Glass 
Book 




/ 






si 

FISKE FUND PRIZE DISSERTATION, No. XXXIV. 



THE PHYSIOLOGICAL AND PATHOLOGICAL 



EFFECTS 
s 

OF 

THE USE OF TOBACCO. 



HOBAKT AMOKY HAKE, M.D. (Unr. of pa.), B.Sc, 

ONE OF THE ATTENDING PHYSICIANS TO THE DISPENSARY FOR THE DISEASES OF CHILD- 
REN, OF THE HOSPITAL OF THE UNIVERSITY' OF PENNSYLVANIA; 
ASSISTANT IN PHYSICAL DIAGNOSIS IN THE 
UNIVERSITY. 




PHILADELPHIA: 

P. BLAKISTON, SON & CO., 

1012 Walnut Street. 

1885. 



^€^ 

<£*' 



Copyright, 1885, by Fiske Fund Trustees, Providence, R. I. 



TO 

DR. HORATIO C. WOOD, 

Professor of Materia Medica and Therapeutics 

IN THE 
UNIVERSITY OF PENNSYLVANIA, 

THIS LITTLE 
BROCHURE IS RESPECTFULLY DEDICATED, 

AS A TRIBUTE TO HIS EMINENCE 
AS AN 

Original Investigator, 

and AS 

A FEEBLE ACKNOWLEDGMENT OF THE MANY KINDNESSES 
WHICH 
HE HAS SHOWN THE WRITER. 



rpHE Trustees of the Fiske Fund, at the annual meeting of the Rhode 
Island Medical Society, held at Providence, June 11th, 1885, announced 
that they had awarded a premium of two hundred dollars to an essay on 
"The Physiological and Pathological Effects of the Use of Tobacco," 
bearing the motto : 

" Quid Nimium Probat, Nihil Probat." 
The author was found to be Hobart Amory Hare, m.d., of Philadelphia, Pa. 

OLIVER C. WIGGIN, M.D., Providence, 

HORACE G. MILLER, M.D., Providence, 

JOHN W. SAWYER, M.D., Providence, 

Tvust&ES 
CHARLES W. PARSONS, M.D., Providence, 

Secretary of the Trustees. 



TABLE OF CONTENTS. 



PAG* 

Preface 7 

Tobacco and What It Is 9 

Nicotine 10 

Nicotianin (?) 11 

The Component Parts of Tobacco Smoke 14 

The Physiological Action 17 

On the General System 17 

On the Nervous System 24 

On the Pupil 28 

On the Circulation 31 

On the Respiration 38 

On the Blood (macro and microscopically) 39 

On the Blood (spectroscopically) 40 

On the Cutaneous Absorption 47 

On the Intestines 48 

On the Action of the Liver on the Effects of the Drug 49 

Pathological Action of Tobacco and its Alkaloid Nicotine 51 

Is the Use of Tobacco Harmful? 67 

Action on Animals 69 

Therapeutic Uses and Effects of Tobacco and Nicotine 71 

Its Use in Tetanus 74 

Its Use in Strychnia Poisoning 77 

Appendix 80 

Pulse Tracings 87 

V 



THE PHYSIOLOGICAL AND PATHOLOGICAL EFFECTS 

OF 

THE USE OE TOBACCO. 



PART FIBST. 



An essay on such a subject as the Committee, or rather Trustees, 
of the Fiske Prizes have chosen is necessarily a difficult task, 
for several reasons. In the first place the title does not state 
whether the essay is to be on a basis of scientific research of an 
original character, or whether the paper is intended, if successful, 
to be printed for popular reading. The writer has therefore 
been somewhat "at sea" as regards the object of the essay, and 
if he has passed the boundary line in either direction in certain 
instances he must beg the reader's forbearance. It has been his 
aim to be as concise as possible in his statements, when such 
conciseness was consistent with clearness, and he trusts that he 
has succeeded in so doing. Many may suppose that as tobacco 
has been for so many years a subject for authorship, both for 
and against its use, much is known about it, in every way. This 
is a mistake, because much of the writing on the subject has 
been done by those who were enemies or friends of the weed, 
and who often knew little or nothing of the subject with which 
they were dealing. Very few, with certain notable exceptions, 
were medical men ; by far the greater portion of the writers 
being curates, etc. As a consequence the bibliographer is at first 
fairly staggered by the great array of books on the subject which 
are put before him, but soon finds that one work is but a repeti- 
tion of its predecessor, containing the same " horrible cases of 
suffering" which have all resulted from the use of the " noxious" 
B 7 



8 THE USE OF TOBACCO. 

drug. On the other hand quite a large amount of experimental 
work has been done in Germany, although very little of it is of 
late date. Various experiments, generally of minor importance, 
have been performed by English and American writers, most of 
this being of much earlier date than that already spoken of. 

The experiments of Sir Benjamin Brodie and others of his 
time 1 are interesting as showing a certain epoch in the history of 
Experimental Therapeutics, the methods of that eminent man 
being far behind those of the present generation. On glancing 
over some old Theses for Graduation, written by members of the 
Medical Department of the University of Pennsylvania about 
1824, the writer came upon one with the following curious "title," 
" The Use of Tobacco in the Resuscitation of the Apparently 
Drowned," in which the writer, having apologized most humbly 
for the apparent cruelty of his methods, proceeded to describe 
how he and a friend had, with commendable desire for knowledge, 
held various dogs, of all sizes, shapes and ages, under water until 
they ceased to struggle, often, indeed, holding them under water 
for "at least three minutes" after all struggles ceased, and then 
attempting to resuscitate them by giving strong decoctions of 
tobacco per os and rectum. The experimenter further went 
on to state that " in no case did the animal revive," which can- 
not be wondered at, considering that tobacco kills by failure of 
respiration. 2 It should have been stated that the writer quoted 
mentioned that it had been said of tobacco, it was an efficient 
remedy in such cases. 3 

Many of the experiments made by the writer were performed 
in his private laboratory, while others were performed in the 
Physiological Laboratory of the University of Pennsylvania. 
These experiments will be marked by a foot-note acknowledging 

1 See portion of this paper relating to Pathological Effects. 

2 See portion of this paper relating to the Physiological Action of Tobacco 
and Nicotine. 

3 This idea was so thoroughly believed in at one time that apparatus for 
using tobacco in such cases was placed at various points on the banks of the 
Seine. 



VARIETIES OF THE PLANT. 9 

their source, throughout the paper. 1 So far as the writer knows, 
no one else has as yet made any thorough examinations of nico- 
tinized blood by means of the spectroscope, and for this part of 
the paper he claims, therefore, entire originality. The experi- 
ments on the nervous system and the pupil were merely intended 
as additional proof of the results reached by others, as were also 
those on the circulation. 



PART SECOND. 



The Tobacco of commerce consists of the dried leaves of 
Nicotiana Tabacum, an annual plant of the natural Order 
Solanacese, which is indigenous to America, but at present is 
cultivated in all parts of the world. Its leaves are broad and 
large. It has a five-parted calyx, a funnel-shaped, five-lobed 
corolla, and five stamens. The flowers grow in panicles at the 
top of the stem, and the fruit is a two-celled, many-seeded cap- 
sule with five valves. The plants are but rarely shrubby in 
character, more frequently being herbaceous, and covered every- 
where by clammy hairs. Besides the species of tobacco already 
mentioned, we have several lesser species, which are also culti- 
vated to a much smaller extent than Nicotiana Tabacum. Some 
of these are indigenous to the East, and others are indigenous 
to America. Nicotiana Rustica, or Green tobacco, is much 
smaller than the American species, and is more hardy. For 
this reason it can often be cultivated in northern regions with 
great advantage. It is sometimes called English tobacco, be- 
cause it was the first kind introduced into England for culti- 
vation. This variety is about one or two feet shorter than the 
American plant, and is a native of the East. 

The famous Shiraz tobacco is derived from the Nicotiana 
Persica, which is much esteemed by many smokers, owing to its 

1 The rules of the Laboratory require that iu consideration of the use of 
the apparatus all work performed therein must be acknowledged. 



10 THE USE OF TOBACCO. 

mildness. Turkish tobacco is milder still, and its leaves are 
small and yellow, or yellowish-brown in color. 

The Nicotiana Repanda of Cuba, and the Nicotiana Multi- 
valvis, Quadrivalvis and Nana of the United States, form the 
rest of the species. 

Indian tobacco, so called, is not one of this race or species at 
all, but is more commonly known as Lobelia Inflata. 

The name Nicotiana is derived from that of Jean Nicot, who 
first introduced the drug on the Continent of Europe. 

The name tobacco is, however, of disputed origin. Many 
consider it a derivative of Tabacos, the Carribean name for pipe, 
and think that the Spaniards transferred the name to the plant 
itself. Others believe that it comes from the name of Tabago, 
one of the islands in the Carribean group, or from Tabacco, a 
province of Yucatan. A few believe it to be derived from 
Tabasco, in the Gulf of Florida. The raw leaf does not possess 
the narcotic and pungent odor of prepared tobacco. This charac- 
teristic odor is developed in some cases by moistening the leaves 
with salt water, and allowing fermentation to take place. The 
Nicotine in the raw leaf is not volatile, owing to an excess of 
acid, and the fermentation just alluded to causes a decomposition 
of the nitrogenous elements of the plant, whereby ammonia is 
formed, which by its alkalinity overcomes the excess of acid, 
and the Nicotine thus becomes liberated. To the ammonia and 
Nicotine is due, to a great extent, the peculiar odor before 
mentioned. 

Many contradictory statements have been made as to the 
quantity of Nicotine in the raw and prepared leaf. 

In the U. S. Dispensatory, 14th edition, by Wood and Bache, 
the following words are used: — "The proportion of Nicotine 
contained in prepared tobacco is asserted to be greater than in 
the fresh." And further on, again, they say: — "It has even 
been made a question whether Nicotine exists at all in the fresh- 
growing leaves." A few lines further on the assertion is again 
made that Prof. Proctor and Prof. Mayer have both decided 
that Nicotine does exist in the raw leaf, and that the latter 



ANALYSES. 1 1 

believes it to be in greater quantity in the raw leaf than in the 
prepared. Boutron and Henry have analyzed tobacco in both 
conditions, and have found the proportion of Nicotine to be 
three or four times greater in the raw leaf than in the manu- 
factured article. 

Xieotine is an acrid, volatile, colorless liquid, with a hot, 
burning taste, and an extremely penetrating odor. Perhaps the 
chief and most important characteristic of this alkaloid, chemi- 
cally speaking, is its entire lack of oxygen, differing from all 
other alkaloids in this respect, with the exception of Conine and 
Sparteine. 

On exposure to light, Xieotine becomes golden in color, and 
if exposed for any time to the air, soon has the consistency of 
tar. Its specific gravity is 1.027, and its chemical formula is, 
according to Meymott Tidy, C 10 H 14 X 2 . 

Many writers, 1 more or less medical, state very positively that 
there is another active principle in tobacco, namely Xicotianin. 
Some of them even go so far as to state the methods which were 
used in obtaining it, and also describe its characteristics and per- 
centages. 

The writer found, however, on speaking to Prof. Worinley, of 
this city, that he knew of no such principle, at least as far as its 
real presence was concerned, saying that he had read of it, but that 
it was probably not an active principle but simply some substance 
which was not characteristic of this drug more than any other. 

Through the kindness of Prof. "Wormley the writer was able 
to find the following reference 2 to the alleged discovery of 
Hermstadt, viz. : Xicotianin. 

Vanquelin 3 analyzed it some time ago — speaking of tobacco — 
and procured an acrid, volatile principle which he called Xico- 

1 Nat'l Dispensatory. Stille and Maisch ; U. S. Dispensatory, 14th Ed.. 
"Wood and Bache : Therap.. Mat. Med. and Toxicology, H. C. Wood : The 
Use and Abuse of Tobacco, Lizars, Edin., 1856: Dunglison's Med. Diet.; 
Worcester's Dictionary. 

2 Christison, On Poisons, Phila., 1845. 

3 Annales de Chimie, lxxi, 139. 



12 THE USE OF TOBACCO. 

tine. " This substance, which was afterwards obtained in a purer 
state as a crystalline body, by Hermstadt, has been more recently 
ascertained by MM. Posselt and Riemans 1 to be nothing other 
than the essential oil of tobacco, which is solid at ordinary tempera- 
tures, and they succeeded in obtaining another principle which 
they consider the true Nicotina. Wood and Bache (loc. cit.) state 
that the essential oil of tobacco is chiefly made up of Nicotine, 
so it is probable, at least, that what MM. Posselt and Riemans 
considered "the true Nicotina" was identical with the active 
principle in the essential oil and therefore identical with the 
substance obtained by Hermstadt. The description of the so- 
called Nicotianin, as concerns its odor, etc., as well as its effects, 
corresponds with the odor of what we know of as Nicotine, and 
the effects which Hermstadt says it produced on him in doses of 
one grain, namely giddiness and nausea, show its action to be 
but a counterpart of that of Nicotine. 

Moreover, those who assert most positively that Nicotine and 
Nicotianin are two separate active principles give no account 
of any analysis proving that they are not one and the same 
thing ; in truth, obtained by different methods and having 
different appearances but only different in these two unim- 
portant particulars. The different methods detailed by Wood 
and Bache (loc. cit.) for obtaining the two principles are briefly 
as follows. 

Hermstadt distilled water from tobacco and allowed the 
liquid to stand for several days, when a white crystalline 
matter arose to the surface which had the odor of tobacco 
and resembled it in its effects; this substance he called 
" Nicotianin." 

The methods given for obtaining Nicotine, consist chiefly in 
the distillation of water containing tobacco and the addition of 
some caustic soda, with sometimes some sulphuric acid in the 
vessel which received the distillate. It will thus be seen that 
the methods for obtaining these substances resemble each other 
very closely indeed. 

1 Hist. Stirp. Helvet. Indig., i, 259. 



NICOTINE — NICOTIANIN. 13 

The writer also found that none of the works on Chemistry 
which were consulted contained any reference whatever to such 
a substance as Nicotianin. 1 Some of these works are considered 
so thorough and authoritative that their not mentioning Nico- 
tianin is almost a proof of its being identical with Nicotine, or 
of its being not an active principle. 

As Nicotine is easily obtained in crystalline form, as, for 
example, from nicotinized blood by the addition of mercuric 
chloride, any claim that Nicotianin is crystalline and Nicotine 
amorphous is untenable. 

Taking all this array of facts against the small authority for 
the presence of Nicotianin, we must conclude that this so-called 
principle does not exist as a separate entity and that it should 
be withdrawn forthwith from our text-books, as at present the 
mistake is impressed upon the student as a fact. The question 
which may be asked by the reader is, how is it possible for such 
a mistake to be perpetuated in works of as high standard as 
those which have been quoted. 

It is very probable that for a certain time the two things were 
supposed to be entirely different, and this supposition soon crept 
into the books which were written at that time. Before many 
years had elapsed the true state of the case was discovered by 
those who were particularly interested in such matters, while 
other writers, copying from old works, without looking into the 
matter, soon managed to perpetuate to the present day a mistake 
which writers on chemistry do. not take pains to correct, simply 
because for them this misstatement was long since shown to be 
a misstatement indeed. 

The quantity of Nicotine in tobacco varies greatly, as may be 
seen from the following list, containing the results of analyses 
of several varieties of the "weed": — 

1 Dragendorf, Pflangen Analyse ; Muter' s Pharmaceutical Chemistry ; 
Attfield's Chemistry; Bloxam's Chemistry; Hermann, Experimental Toxi- 
cology ; Fownes' Chemistry ; Pinner, Organische Chemie ; Schorlemmer, 
Chemistry of Carb. Compounds; Wormley's Micro- Chemistry of Poisons ; 
Watts' Dictionary of Chemistry ; Handbook of Modern Chemistry, Meymott 
Tidy; Wohler's Organic Chemistry. 



14 THE USE OF TOBACCO. 

That from 

The Department of Lot in France 8 per cent. 

Kentucky 6-8 " 

Virginia 6-9 " 

Maryland 2.3 " 

Havana — 2 " 

It should be remembered that these percentages are from the 
dried leaf and from tobaccos grown in the regions named, for the 
plant changes both its appearance and constituents according to 
the soil and climate in which it is placed. The seed of Havana 
tobacco planted in Kentucky would, in the course of a few crops, 
change its proportion of Xicotine from minus 2 per cent, to 6 
or 8 per cent. 

Recently, M. Le Bon announces, after long research, that he 
has obtained from tobacco smoke (1) a notable quantity of 
Prussic acid; (2) a new alkaloid of a very agreeable odor, 1 but 
as poisonous as Xicotine. The fiftieth of a drop is sufficient to 
produce paralysis and death. 2 

Dr. Zulinsky has lately published, in a Polish medical journal, 
the results of many experiments with tobacco smoke on men and 
animals, 3 and declares that the poisonous characters of the smoke 
are not alone due to the Xicotine which it contains. He found 
that even after all Xicotine is removed from the smoke, it still 
remains very poisonous in large quantities. The second poison 
which he found in the smoke he calls "Colidin." 4 This sub- 
stance was not first discovered by Zulinsky, since, in 1871, MM. 
H. Yohl and Eulenberg 5 found it in the smoke along with 
pyridine, picoline, lutidine, parvoline, corodine, rubidine and, 
probably, viridine. The same investigators also found that 
oxygen, nitrogen, carbonic acid and marsh gas are found in 
cigar smoke. 

1 A proof that it cannot be what has been called Nicotianin, since that 
11 alkaloid" (?) was supposed to resemble Xicotine in this respect. 

2 Phila. Med. Times, vol. of '79-80, p. 623. 

3 See Brit. Med. Journal, Oct, 25th, '84, p. 824. 

4 Probably the same as found by M. Le Bon (loc. cit). 

5 Pharm. Jour., Jan., 1872, p. 567. 



CONSTITUENTS OF TOBACCO SMOKE. 15 

These observers also state that there is no Nicotine in tobacco 
smoke, although the tobacco from which the smoke was taken 
contained 4 per cent, of the alkaloid. Zeise also made this 
statement, as early as 1843. Vohl and Eulenberg believe the 
Nicotine which other analysts have supposed to be present to be 
nothing more than the Nicotine bases, such as those already 
named. For the rest of their opinions and methods of pro- 
cedure, the writer must refer the reader to their original paper. 
They experimented with a mixture containing these bases, and 
the results were the same as when Nicotine was administered. 
Even if they are correct in their supposition that there is no 
Nicotine in tobacco smoke, 1 it concerns us but little, since the 
effects produced are the same. Although their experiments were 
most exhaustive, we can hardly accept their results as positively 
true, in the face of the results of so many able men, 2 unless future 
analysis confirms them . Dr. Krause, 3 of Annaberg, besides finding 
Nicotine, hydrogen sulphide and cyanogen in tobacco smoke, 
found carbonic oxide and carbonic acid, the former in varying 
amounts. According to this writer, the quantity of these two 
constituents of tobacco smoke depends upon the kind of tobacco 
used and the way of filling the pipe, etc. The manner in which 
the smoke is drawn also affects these products by influencing 
combustion. 

From twelve experiments made by Dr. Krause, it appears 
that the quantity of carbonic oxide varied from 5.2 to 13.8 in 
100 of smoke, the average being 9.3. u As the consumer of the 
weed never gives out all the smoke he takes in, a certain amount 
of carbonic oxide poisoning is inevitable." He further states 
that the sickness of the " first smoke " is largely due to the 
inhalation of this poison, as well as the Nicotine. 4 

1 Taylor's Med. Jurisprudence — Reese— p. 255, also makes the assertion, 
that tobacco smoke contains no Nicotine. 

2 See Dragendorf — Pflangen Analyse. 

3 The Sanitary Record, Nov. 13, 1875. 

4 Herr Kissling, of Bremen, after many experiments, agrees with all the 
writers quoted except Vohl and Eulenberg. See Dingier' s Polytechnisches 
Journal. 



16 THE USE OF TOBACCO. 

Dr. Zulinsky {loo. cit.) states that some of the lighter-colored 
tobaccos are more injurious, owing to the chemical bleaching, 
than the darker brands, and says, what sounds like common sense, 
that the light-colored tobaccos generally give a hotter smoke, 
owing to the greater quantity of woody fibre which they contain. 
He admits that the dark brands of tobacco are readily adulter- 
ated, but believes them, when pure, to be the best for such use 
as smoking or chewing. The amount of Nicotine in tobacco 
smoke varies greatly, according to the distance which it traverses 
before reaching the smoker. The longer the pipe stem, the less 
Nicotine passes into the mouth, and, therefore, in the cigarette 
and cigar more Nicotine is inhaled than when a pipe is used. 
As Nicotine is volatile, much of it is destroyed by the fire, and 
the balance is partly caught, either by the pores of the pipe or 
the fibres of the cigar. As it has already been shown that some 
of the Nicotine is driven off in the process of manufacture, it 
will readily be seen that very little of the poison, after all, 
reaches the smoker. 

In the old pipe, so soaked with Nicotine as to be unable to 
absorb more of the drug, it stands to reason that more Nicotine 
reaches the smoker, and the moral of this is that the pipe is the 
safest method of using the weed as long as it is comparatively 
new, but that the cigar is preferable to an old pipe. Every one 
knows how powerfully an old pipe smells, and how apt it is to 
" upset" even an old smoker who picks it up to try it. The 
custom of the Turks is to pass the smoke first through water 
and then through a long tube before it enters the mouth, and 
this is probably the wisest way of using the " weed." 

The yellowish tinge of the tobacco smoke when puffed from 
the mouth is due, in great part, to the condensation of the Nico- 
tine as soon as it loses the heat by which it was partially volatil- 
ized in the pipe. 

When tobacco smoke in any quantity is drawn through water 
Nicotine in an impure state will discolor the water and adhere 
to the sides of the vessel at the water line. Smoke derived from 
an apparatus of this kind will be always whiter and lacking in 



PHYSIOLOGICAL ACTION. 17 

the yellowish hue described above. The " biting of the tongue," 
which is often so severe in smoking, is brought about by several 
causes which are nearly all absent in the best brands of tobacco. 
These are as follows, in order of their importance, (1) Nicotine, 

(2) Heat, varying in amount with the woody fibre in the tobacco, 

(3) The irritating effects of carbonic acid. The reaction of 
tobacco smoke is alkaline, owing to the Xicotine, or as Dr. Rich- 
ardson 1 states the presence of ammonia. The same author be- 
lieves that the lassitude and sleepiness produced by prolonged 
smokiDg is due to this agent — carbonic acid. Taking it for 
granted that this statement is correct as far as it goes, we can 
hardly avoid the thought that these symptoms must also be 
somewhat the result of the Nicotine which has been inhaled. 

While it has been shown that an infinitesimal amount of 
Nicotine in reality reaches the smoker, yet the fact must not be 
overlooked that a very minute amount of the alkaloid can cause 
death ; even so small a quantity as one thirty-second of a drop 
will kill cats and dogs. 



PART THIRD. 



PHYSIOLOGICAL ACTION. 
I. ON THE GENERAL SYSTEM. 

Dr. W. A. Hammond, of New York, has probably made more 
extended and thorough researches as to the effects of smoking 
on the system than any other experimenter, and the writer there- 
fore quotes from his paper 2 ad libitum. 

"My manner of living during the succeeding experiments 
was as follows : I arose every morning at 6 o'clock and retired 
to bed at 11. I was thus awake seventeen hours and asleep seven 
hours. The seventeen waking hours were thus appropriated : 
ten were assigned to study, of as uniform a character as possible ; 

1 For and Against Tobacco. London, 1865, p. 5. 

2 Amer. Jour, of the Med. Sci., Oct., 1856, p. 315. 



18 THE USE OF TOBACCO. 

five to daily duties, recreation, etc., and two to a uniform system 
of physical exercise. The experiments on tobacco embraced the 
consideration of its effects under the following conditions : — 

" 1st. When food was sufficient to maintain the healthy balance 
of the system. 

" 2d. When a deficiency of aliment was ingested." 

He states that he had not previously been in the habit of 
using tobacco in any form, but had occasionally smoked a cigar 
without any perceptible effect arising therefrom other than slight 
nervous excitement. He never in his life either chewed tobacco 
or used snuff. The tables following are those of Dr. Hammond, 
but the writer has, for the convenience of the reader, grouped a 
few of the constant factors in Dr. Hammond's experiments in 
such a way as to make comparison more easy and the different 
points more salient. 

It should be constantly kept in mind that Tables Nos. 1 and 
2 embrace the time during which the experimenter was well 
nourished, while Tables Nos. 3 and 4 embrace the time when 
nutriment was deficient. Also that in Tables Nos. 1 and 3 no 
tobacco was used ; but in Tables Nos. 2 and 4, Dr. Hammond 
smoked 450 grains of tobacco a day, or 150 grains after each 
meal, which equals about two cigars. 

He allowed five days to elapse between the series of experi- 
ments with sufficient nutriment and those of insufficient nutri- 
ment, in order that the system might be in its normal condition 
for the second series. On the sixth day, or the first day of the 
second series, he cut down his daily amount of bread to twelve 
ounces and his meat to ten ounces. It will be seen from the 
tables that Dr. Hammond weighed about 225 pounds, and, 
therefore, was not what would generally be called a lean man, 
or one of a nervous or excitable temperament. This is worthy 
of consideration, as tobacco affects people of the latter class more 
than those of heavy build, etc. 



ACTION ON THE GENERAL SYSTEM. 



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THE USE OF TOBACCO. 



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ACTION OX THE GENERAL SYSTEM. 21 

In regard to the results of these experiments, he sums up as 
follows : — 

(In Tables 1 and 2.) My weight, under the use of tobacco, 
increased an average of .07 of a pound, the carbonic acid 88.04 
grains, the free acid of the urine 4.93 grains, the uric acid 5.88 
grains, the phosphoric acid 23.83 grains, and the sulphuric acid 
4.41 grains. On the contrary, the quantity of aqueous vapor 
decreased 299.46 grains, the faeces .01 of an ounce, the urine 
1.87 ounces, the urea 42.37 grains, and the chlorine 23.04 grains. 

(In Tables 3 and 4.) It will be seen that the loss of weight, 
owing to deficient food, was lessened from the first, and entirely 
overcome on the fourth day, by the use of tobacco. In other 
words, he lost .37 of a pound a day without tobacco smoking, 
but only lost .09 of a pound a day when tobacco was used. 

The excretion of carbonic acid from the lungs was not per- 
ceptibly affected, on the average, by the use of tobacco; the 
amount of aqueous vapor exhaled was reduced 159.94 grains, 
the faeces 1.92 ounces, the quantity of urine 1.51 ounces, the 
urea 62.54 grains, and the chlorine 15 grains. The free acid of 
the urine was increased 3.03 grains, the uric acid 4.52 grains, 
the phosphoric acid 30.23 grains, and the sulphuric acid 8.35 
grains. The desire for food was not nearly as great when he 
smoked as when he did not. 

The conclusions he draws from these results are as follows : — 

That smoking does not affect the secretion of carbonic acid 
through the lungs, but that it lessens the amount of aqueous 
vapor given off in respiration, diminishes the fseces, lessens the 
amount of urine and the quantity of its urea and chlorine, and 
increases the amount of free acid, uric, phosphoric and sulphuric 
acids eliminated by the kidneys. That tobacco, when food is 
sufficient to preserve the weight of the body, increases that 
weight, and when the food is not sufficient to preserve the 
weight of the body, tobacco restrains the loss. His experiments 
prove that smoking does not prevent the consumption of fat, 
but does retard metamorphosis of the nitrogenous tissues. 

The writer has reached different conclusions as to the effect 



22 THE USE OF TOBACCO. 

EFFECT OF SMOKING OX THE ELIMINATION OF URINE. 



Day. 


Hour. 


Amount of 
Urine Passed. 


Amount of 
Water Ingested. 


Temperature 
of Atmosphere. 


Remarks. 


1st. 


9 A.M. 

2.30 p.m. 
10.30 p.m. 


OZ. DR. 

6 4 1 

J°> J Twenty-four (24) oz. 29° Fahr. 

28 6 1 


No tobacco. 


2d. 


9 A.M. 
4 P.M. 
11 P.M. 


2 6 

13 

10 4 

26 2 


Thirty (30) oz 


30° Fahr. 


No tobacco. 


3d. 


9 A.M. 
3 P.M. 
8 P.M. 


5 1 

9 7 

10 

25 


Thirty (30) oz. 


27° Fahr. 


No tobacco. 


4th. 


9 A.M. 

2.30 p.m. 
9.30 p.m. 


8 

12 2 

7 3 

27 5 


Thirty-four (34) oz. 


32° Fahr. 


No tobacco. 


5th. 


9 A.M. 
1 P.M. 

11.30 p.m. 


9 

13 4 

11 

33 4 


Thirty- four (34) oz. 


31° Fahr. 


No tobacco. 



Total amount of water passed in 5 days, 140 oz. and 7 dr. 

Total amount of water ingested in 5 days, 152 oz. 

Average temperature of atmosphere, 29§° Fahr. scale. 

Difference in quantity between water passed and ingested, 11 oz. and 1 dr. 



Day. 


Hour. 


Amount of 
Urine 
Passed. 


Amount of 
Water Invested. 


Amount of 

Tobacco 

Consumed. 


Temperature 

of 
Atmosphere. 


Remarks. 


1st. 


9 a.m. 

2.30 p.m. 
10.30 p.m. 


OZ. DR. 

7 4 

12 1 

12 1 

31 6 
4 6 

13 

10 4 

28 2 


Twenty-six (26) oz. 


100 grs. 


30° Fahr. 


Tobacco used. 


2d. 


9 a.m. 

4 P.M. 
11 P.M. 


Thirty (30) oz. 


100 grs. 28° Fahr. 


Tobacco used. 


3d. 


9 A.M. 

2.30 p.m. 

9 P.M. 


5 1 I 

9 7 

10 Thirty -two (32) oz. 1 100 grs. 24° Fahr. 

25 | 


Tobacco used. 


4th. 


9 A.M. 

2.30 p.m. 
9.30 p.m. 


8 

12 2 

9 3 

29 5 


Thirty-two (32) oz. j 100 grs. 20° Fahr. 


Tobacco used. 


5th. 


9 A.M. 

1 P.M. 

11.30 p.m. 


9 

13 4 

11 

33 4 


1 
Thirty -two (32) oz. > 100 grs. 32° Fahr. 


Tobacco used. 



Total amount of water passed in 5 days, 147 oz. and 7 drs. Difference in table No. 1, 11 oz., 1 dr. 
Total amount of water ingested in 5 days, 152 oz. " " No. 2, 4oz.,ldr. 

Average temperature of atmosphere, 27° Fahr scale. Increase, when smoking, 1 oz. 
Difference between water passed and ingested, 4 oz. and 1 dr. ' °' 



ACTION ON THE GENERAL SYSTEM. 23 

which smoking has on the elimination of urine. On the preced- 
ing page will be found the tables from which he draws these con- 
clusions. The duration of each experiment was five consecutive 
days, with an interval of five days between the two series of experi- 
ments, in order that the results might be entirely independent of 
each other. Care was exercised that the amount of water ingested 
during the two series should be identical, although it will be 
seen that- the daily amount varied slightly. This variation has 
no effect on the results or conclusions, as the statistics are treated 
in bulk. The tobacco was used in the form of cigarettes, each 
cigarette being weighed before using, and the stump weighed 
and its weight subtracted after smoking. The same weight of 
tobacco (100 grains) was smoked each day, and probably pro- 
duced as full an effect as a much larger quantity would produce 
in one accustomed to the use of the drug, since the person who 
performed these experiments never smokes. No liquid food 
was taken, and the diet during the two series was in every way 
alike. The water was taken generally at meal times. 

The difference in temperature between the two series is not 
sufficient to have caused the increased quantity of urine noted. 
It certainly is a fact that tobacco itself does increase the quantity 
of urine when taken internally. Claude Bernard 1 asserts, w T ith 
others, that this is so. 

Stille 2 also believes that tobacco increases diuresis, for he says, 
" On the whole, it seems probable that tobacco might with 
advantage take the place of Digitalis in the treatment of many 
dropsies for which that medicine is now prescribed." He also 
quotes the results of Fowler in cases of dropsy. To seventy- 
nine cases of dropsy tobacco was given, with the result of twenty- 
eight cures and thirty-two relieved. It seems scarcely probable 
that tobacco when taken internally should increase diuresis and 
when smoked should decrease the elimination of urine. It is 
an important fact to bear in mind that during Dr. Hammond's 
experiments the temperature was high, and therefore his urine 

1 Substances Toxique, p. 410. 

2 Therap. and Mat. Med., p. 384, Vol. II. 
C 



24 THE USE OF TOBACCO. 

was naturally decreased by the loss of fluid in perspiration. 
The observations of the writer were made in winter, perspiration 
being, therefore, at a minimum. That Nicotine is eliminated by 
the kidneys is certain, since it can be recovered from the urine. 
The fact that the quantity of urine is increased points toward 
this conclusion. 

II. ACTION ON THE NERVOUS SYSTEM. 

Krocker has proved conclusively that the convulsions in Nico- 
tine poisoning are not cerebral, as they occurred in frogs whose 
cerebrums had been extirpated. Vulpiau found that cutting off 
the arterial supply of a limb did not prevent the convulsions. 1 

Krocker confirmed this by dividing the nerve trunk, when the 
convulsions ceased in that limb. Both the preceding experi- 
ments were performed by the writer with a corresponding result ; 
thus proving that the first, or convulsive stage of the poisoning 
is due to the action of the drug on the cord. What this action 
is, it is difficult to decide. The first thought which occurs to 
one is that this primary stage of the poisoning, with its convul- 
sive movements, is due to excitation of the motor tract of the 
spinal cord. 

That drugs of a depresso-motor action can produce convul- 
sions is so well known that it is unnecessary to state it here, and 
originally it was the custom to consider such phenomena as 
being the result of a primary stimulation, ere the more powerful 
and true action of the drug came on. Prof. Fraser, of Edin- 
burgh, 2 and Drs. Ringer and Murrell, 3 have found that in Atropia 
poisoning, 4 convulsions and paralysis are often present at one 
and the same time, that is to say, the animal whose whole cord 
is apparently paralyzed by atropia may suddenly be seized by a 

1 Comptes-Rendus de la Soc. de Biol., 1859, page 151, quoted by Wood; 
Mat. Med. and Toxicology, p. 361. 

2 Trans, of the Royal Soc. of Edinburgh, 1869, xxv, 450. 

3 Med.-Chir. Trans., vol. lix, 1876, p. 389; and Jour, of Anat. and 
Physiology, 1877, p. 517. 

4 These experiments on atropia are quoted merely for the sake of illus- 
tration. 



ACTION ON THE NERVOUS SYSTEM. 25 

tetanoid convulsion. The explanation of this is, that, in the 
first stage of atropia poisoning every part of the cord is para- 
lyzed, and as the effects of the drug pass off they release the 
motor cells of the cord, but leave the hypothetical inhibitory 
centres still paralyzed. The result is that an ungoverned ex- 
plosion of nerve force takes place on every impulse which the 
cord receives from the periphery, the so-called hypothetical reflex 
inhibitory centres being incapable of restraining the discharge. 
[Although Setschenow long since demonstrated the existence of 
a reflex inhibitory centre in the base of the brain, and such 
eminent physiologists as those already mentioned, together with 
Ferrier, Bernstein, Hermann and Foster, supposed such centres 
to exist in the cord, no proof positive of their existence has been 
adduced. In some researches recently made on choreic dogs, in 
the Physiological Laboratory of the University of Pennsylvania, 
the writer's attention was called, by the experimenter, to the fact 
that galvanization of the sciatic nerve after section of the cord 
produced temporary inhibition of the movements. 1 This inhibi- 
tion probably was due to stimulation of these very centres, and 
was only temporary, because the centres became exhausted. It 
seems, then, that the presence of these cells is sufficiently probable 
to warrant the writer in dropping the term hypothetical.] As 
the drug with which this paper deals is most undoubtedly a 
depresso-motor, it seems to the writer that the convulsions of the 
primary stage of Nicotine poisoning must be due to just this 
depression of the spinal reflex-inhibitory centres. 2 

It certainly is more logical to believe that a drug is always 
a depressor of nervous matter, never mind what the outward 
results may be, than to believe it to be an excito-motor at first 
and a depresso-motor afterwards. 

Although in the experiments on atropia 3 (loo. cit.) the paralysis 

1 This result is interesting, as showing that choreic movements are probably 
spinal in their origin, as well as cerebral, as generally supposed. 

2 For an interesting article on Convulsions due to this cause, see Art. by 
Eeichert, Aug. 13th, 1881, in the Phila. Med. Times. 

3 The experiments quoted can be largely found in Wood's Therapeutics. 



26 THE USE OF TOBACCO. 

came first and the convulsions afterwards, the reversed order of 
things is perfectly possible and probable with Nicotine. In 
other words, there is no possible reason why the poison should 
not in this primary or convulsive stage attack the inhibitory 
spinal centres, leaving the rest of the cord unscathed for the 
time being; but as the poison becomes more absorbed, its pre- 
dominating action — namely, that of depression — asserts itself, 
and we at last have the true character of the drug before us. 
The paralysis of the second stage of Nicotine poisoning is due to 
spinal depression, for the writer found that tying the artery of a 
limb did not prevent the limb from being equally powerless with 
the unprotected leg in the second stage. Krocker also performed 
this experiment with a like result. Galvanization of the cord, 
the writer found, caused no movements in the limbs in this 
stage. • 

In order to discover whether the nerve trunks were paralyzed 
in the stage under consideration, the writer poisoned a frog by a 
hypodermic dose of -gV drop of' Nicotine. The sciatic nerve at 
first — that is to say, at the very beginning of the palsy — reacted 
under the galvanic current, but soon refused to respond even to 
a current of increased power. This would appear as if the 
paralysis having first attacked the cord, soon after extended to 
the nerve trunks themselves. Krocker tied the artery 1 in the 
leg low down, so as to protect the peripheral endings of the 
nerves, galvanized the nerve above the ligature, and found, by 
comparing the results with those obtained by galvanization of 
unprotected nerves, that the peripheral nerve endings were para- 
lyzed before the nerve trunks. In an experiment, the counter- 
part of that performed by Krocker, it seemed to the writer as if 
the nerve trunks and peripheral endings were paralyzed simul- 
taneously. During the stage of excitement, there is always 
present fibrillary muscular contraction, which never, at any 
time, amounts to a convulsion in itself. The writer repeated an 
experiment of Krocker's and reached the same results. Tying 
a tight ligature around the leg of a frog and injecting Nicotine 
1 Therap., Mat. Med. and Tox., H. C. Wood, p. 362. 



ACTION ON THE NERVOUS SYSTEM. 27 

into the leg below the ligature, nothing more violent than the 
ordinary fibrillary muscular contraction was noticed; this proves 
conclusively that the convulsions are not due to peripheral 
excitation. 

The writer also tied the artery and nerve of the leg and 
injected Nicotine into the distil part of the limb, with naturally 
the same result as above stated. On the muscular fibre itself, 
Nicotine seems to have little or no effect, as the writer found 
that the muscle, even after death, responds readily to the galvanic 
current. 

Yulpian and Rosenthal both agree in asserting that the 
sensory nerves are not affected by the drug. Lautenbach, 
however, proves very conclusively, to his own mind, that sen- 
sibility is abolished. 1 He found that an animal poisoned by 
the administration of one drop of Nicotine tost the sense of 
touch and also of sensation in general, and walked about the 
room placing the dorsal aspect of the foot to the floor instead 
of the plantar surface. He also says, in support of his opinion, 
that when strong electrical irritation of the sciatic nerve is 
caused, the pupil does not dilate, "this latter being the most 
delicate test to determine the absence of sensibility." The 
symptoms which have been quoted afford ground for the opinion 
of Lautenbach, although the resting on the dorsum of the foot 
might be due to other causes, such as muscular weakness, or 
inco-ordination or palsy of the extensor muscles. 

That the galvanization of the sciatic nerve, just mentioned, 
proves the sensory nerves to be paralyzed or impaired, is to be 
strongly doubted, or even thrown aside, since it has been posi- 
tively proved by other observers that galvanization of the cervical 
sympathetic with the strongest currents fails to cause dilatation 
of the pupil, 2 either because of oculo-motor spasm, sympathetic 
paralysis peripherally, or perhaps both. 

1 Phila. Med. Times, May 26, 1877. Rene also asserts that sensibility is 
destroyed and that Setschenow's centre is paralyzed. See These de Nancy, 
1878. 

2 See Action on the Pupil. 



28 THE USE OF TOBACCO. 

III. ACTION ON THE PUPIL. 

A drop of a solution of Nicotine (1 drachm to the ounce) was 
dropped into the eye of a rabbit and caused immediate myosis, 
the other eye remaining with a normal pupil. To another rabbit 
the writer gave a hypodermic injection of Nicotine and in a very 
short time both pupils were contracted. Krocker and the writer 
both found that the contraction took place in cut-out eyes. 
Hirschmann asserts, too, that Nicotine always contracts and never 
dilates the pupil/ but Stilly on the contrary, asserts that the pupils 
in the primary stage are uniformly dilated. 2 Taylor's Medical 
Jurisprudence, by Reese, page 253, asserts this also, but as neither 
writer mentions his reasons or authority for such a statement, it 
will be evident to the reader that their assertions are lacking the 
importance which they otherwise might possess. Hirschmann 
has found that galvanization of the divided cervical sympathetic 
fails to cause dilatation of the pupil, when contraction has been 
brought about by the use of Nicotine 3 dropped into the eye. 
Krocker has confirmed this. He found, however, that while 
Nicotine contracts the pupil in any dose, large or small, the 
sympathetic was only affected when large doses were used. In 
other words, he found that the sympathetic when stimulated by 
the galvanic current could overcome a contraction, when such 
contraction was brought about by a small dose of the drug; but 
if the contraction was the result of a large dose, he found that 
stimulation of the sympathetic produced no effect, that is, it was 
paralyzed. 

It seems to the writer that this is almost proof positive that 
Nicotine produces pupillary contraction by stimulation of the 
oculo-motor, aided, when the dose has been large, by paralysis 
of the sympathetic peripherally. The objection may be raised 
that the sympathetic is not really paralyzed by the Nicotine, but 
that such a severe spasm is brought about by the drug's action 
on the oculo-motor that the sympathetic is unable to overcome 

1 Bulletin de Therap., lxv, 561. 

2 Therap,, Mat. Med., vol. ii, p. 364. 

3 Reichert's Arclriv., 1863, quoted by H. C. Wood. 



ACTION ON THE PUPIL. 29 

the said spasm. It seems to the writer that this is hardly pos- 
sible as Krocker found that galvanization of the sympathetic, 
when the drug was in large amount, had no effect on the con- 
traction. It is clear that the spasm must be very great when 
galvanization of a divided cervical sympathetic whose peripheral 
endings are in good condition produces no effect. 

As atropia dilates the pupil by paralysis of the oculo-motor 
peripheral endings, and probably by stimulating the peripheral 
endings of the sympathetic, 1 its action is directly antagonistic to 
that of Nicotine, provided, of course, that the conclusions of the 
writer are correct. 

The writer dropped a single drop of a solution of Nicotine 
(1 5 to the oz.) into the eye of a rabbit, and the pupil immedi- 
ately contracted. After waiting a few moments, in order that 
the Nicotine might have its full effect, he next dropped ten drops 
of an atropia solution (4 grs. to 1 oz.) slowly into the same eye, 
and in a short time 1 the pupil returned to its normal size and 
corresponded with the untouched eye. The same experiment 
was performed on the other eye, except that the order of adminis- 
tration of the two drugs was reversed while the doses remained 
the same. The usual dilatation of the pupil took place after the 
atropia, 2 likewise the contraction after the Nicotine ; but it was 
noted that although atropia overcame the contraction in the 
first experiment, sufficiently to cause the pupil to return to its 
normal size and no more, the Nicotine in the second experiment 
overcame the dilatation not only enough to bring the pupil to 
its former size but also to contract it still further, although not 
to the same extent as when no atropia was used. There are 
several ways of accounting for what at first sight appears a 
curious difference. 

It may have been due to some one of the drugs escaping 
largely from the eye before its effects could take place, or, as the 

1 See Therapeutics, Mat. Med. and Toxicology, by H. C.Wood, page 256, for 
a very clear account of evidence proving that this assertion is probably correct. 

2 Fifteen or twenty minutes elapsed in each case, as usual, before the 
atropia began to fully act. 



30 THE USE OF TOBACCO. 

volume of the atropia in the first experiment was greater than 
that of the Nicotine, the atropia may have washed some of the 
Nicotine away; whereas, in the second experiment, the Nicotine 
being dropped into the eye last, its full effect could take place. 
Nicotine is so acrid and so irritating to the eye that it always 
produces a certain amount of lachrymation, which would natur- 
ally wash part of the drug away. As atropia has a local anaes- 
thetic action on the eye, the dropping of Nicotine does not cause 
such a large amount of lachrymation when atropia has previ- 
ously been instilled into the eye, as when Nicotine is dropped 
into an eye whose usual amount of sesthesia is preserved, and, 
therefore, in the atropinized eye there was less danger of the 
Nicotine being washed away, and consequently, perhaps, a greater 
opportunity for the Nicotine to act. The writer also experi- 
mented on frogs in the same manner, and obtained the same 
results. He found that the drugs acted more evenly, and that 
the reversal of the order of their administration had no percep- 
tible effect as to their respective actions. Krocker asserts that 
Nicotine causes contraction of the pupil when the eye has been 
enucleated, which, if true, proves that the action of the drug is 
largely peripheral, at any rate. The writer has confirmed the 
experiments of Krocker, using the cut-out eyes of frogs. In 
every case quite as much contraction took place in the enucleated 
eyes as when they were yet connected with the governing centres. 
The writer, furthermore, performed the experiments with the 
atropia and Nicotine as antagonists. In these experiments, how- 
ever, he dropped the eyes into the two solutions of the same 
strength as before. In summing up the results of these experi- 
ments, we find : — 

First. That Nicotine causes contraction of the pupil. 

Second. That the contraction of the pupil is due to peripheral 
action on the motor nerves of the eye, or, rather, the nerves 
governing the movements of the pupil. 

Third. That this myosis is caused by the drug stimulating 
the peripheral endings of the oculo-motor and paralyzing the 
peripheral endings of the sympathetic, when the drug is in very 



ACTION ON THE CIRCULATION. 31 

large quantity. This is proved by the facts that contraction is 
due to oculo-motor power, that the contraction takes place in the 
cut-out eye, and also that galvanization of the divided cervical 
sympathetic does not dilate the pupil when Nicotine has been 
administered, the last-mentioned fact proving that the sympa- 
thetic is paralyzed. Additional, though not positive, proof of 
this is the antagonistic effects of atropia to those of Nicotine, as 
detailed above. Another proof of peripheral action is, th'at a 
pupil contracted by an internal dose of Nicotine remains con- 
tracted after the eye is cut out. 

IV. ACTION ON THE CIRCULATION. 

The study of the action of Nicotine on the circulation is not 
as easy as the study of its action on other portions of the 
organism. 

This is because the drug has totally opposite effects if given 
in large or small doses. Thus, large doses of Nicotine paralyze 
the pneumogastric, smaller doses stimulate it, and still smaller 
doses seem to have but little, if any, effect on it. 

When variations in dose bring about such variation in result, 
and when the drug is so powerful as to affect the circulation in 
such small doses as the sixty-fourth of a drop, it will readily 
be seen that very contradictory results will often be present, 
caused by some slight mistake in the amount of the drug 
administered. 

Proceeding at once to our subject proper, let us trace the 
drug's action in this part of the body, beginning with its action 
on cold-blooded animals. 

If a frog's heart be exposed in situ by laying open the thoracic 
cavity, and a small drop (-gV) of Nicotine be placed in the peri- 
cardial sac, the heart will first pause in diastole, then begin to 
beat slowly, and in a few moments begin to increase its pulsa- 
tions, and also, apparently, the force of its contractions. This 
is again followed by a fall of rate and force. The writer excised 
four frogs' hearts, and placed them in strong solutions of Nico- 
tine. Their movements were increased in rapidity and force. 



32 THE USE OF TOBACCO. 

Dr. W. T. Benharn 1 found that the pure drug painted over 
the heart of a rabbit, after the organ had been excised, did not 
stop its movements but increased them. He also injected the 
poison into the heart cavities without arresting the movements. 
It is evidently a fact, then, that Nicotine does not affect the heart 
muscle. Traube 2 injected Nicotine into the jugular vein of a 
curarized animal, maintained artificial respiration, and found 
that the pulse and arterial pressure sink at once to half their 
original position, but in about twenty seconds rise rapidly, the 
arterial pressure increasing to two and a half times its normal 
grade. The pulse rate also is much quicker. This increased 
action lasts for about a minute, when the arterial pressure and 
pulse rate commence to fall and they soon drop far below their 
normal position. 

The experiments of the writer were performed on non-curar- 
ized dogs, 3 and the results are exactly the same as those of 
Traube's. 4 The only advantage that the writer could discover, 
in using curare, was the avoidance of the excessive increase of 
pulse force, which on one or two occasions ruined his experiments 
by driving the pen, in one grand upward sweep, far above the 
drum, driving the mercury and soda solution right out of the 
tube and filling it with blood. It was for this reason that he 
gave the two largest dogs but the -fa of a drop, thereby avoiding 
the excessive pressure. This rise was probably due to asphyxia 
as well as cardiac stimulation, since when Jj of a drop was given 
to the curarized animal the rise was not so sudden or so great. 
To tabulate the results we find : — 

1st. That when Nicotine is injected into the jugular vein there 
is a decrease of arterial pressure and rate. 

2d. That this is followed very shortly by an increase of pulse 
rate and pressure, which soon drives the pen above the drum. 

1 West Riding Lunatic Asylum Reports, vol. iv, 1874. 

2 Allgem. Med. Central- Zeitung, 1862, quoted by H. C. Wood. 

3 See Tables showing results of these experiments on following pages. 

4 See end of paper for some typical tracings of Nicotine's action on the 
circulation. 



ACTION ON THE CIRCULATION. 



33 



3d. That this stage of stimulation is followed in a few min- 
utes by another stage of depression of rate and pressure. 

4th. That according to both series of experiments there is, 
after some minutes (about twenty), an increase of pulse rate 
considerably beyond the normal number, and according to the 
experiments of the writer, a decrease of arterial pressure. 

The lowering of pulse rate must be due to one, or perhaps 
two, of several causes. Either the drug depresses the heart's 
motor apparatus directly or stimulates the cardio-inhibitory 



TABLE SHOWING PULSE KATE AND PRESSURE. 1 

The arterial pressure is expressed in millimeters. 



Time. 


Drug. 


PlTLSE. 


Arterial 
Pressure. 


4.20 








4.20 10 




114 


110-112 


4.20.11 


sV drop. 






4.20.21 




30 


108- 45 


4.20 31 




60 


40- 59 


4.20.41 




60 


58- 62 


4.20.51 




72 


63- 91 


4.21.01 




108 


95-114 


4.21.11 




78 


116-121 i 


4.21.21 




102 


115-141 


4.41.21 




144 


43- 56 


4.41.31 




144 


42- 50 


4.41.41 




144 


45- 50 


4.41.51 




138 


42- 55 



DOG No. 1. 



Weight of dog ahout 18 pounds. 



Non-curarized. 



Injected into the Jugular vein. 

Lowering of pulse rate and arterial pressure in the first 
stage. 



Increase of pulse force and rate in the second stage. 

At this point pen was driven above drum. 
Twenty minutes later shows tracing of fourth stage, or 
increase of pulse rate. 



All these tracings were taken by means of the mercurial kymographion of Fick. 



TABLE SHOWING PULSE KATE AND PRESSURE. 



Time. 

4.40 

4.40.10 

4.40.11 

4.40.21 

4.40.31 

4.43.31 
4.43.41 
4.43.51 
4.44.01 
4.44.11 
4.44.21 
4.44.31 
4.44.41 



Drug. 


Pulse. 


Arterial 
Pressure. 




108 


75- 80 


3*2 drop. 








90 


70- 27 ! 




60 2 


69-130 




90 


111-115 




108 


115-110 




114 


108-105 




106 


103-107 




102 


101-104 




97 


98-101 




98 


102-105 




95 


101-103 



DOG No. 2. 

Non-curarized. 

Weight of dog about 21 pounds. 

Injected into Jugular vein. 

Showing lowering of pressure and increasing diminution 

of rate. At this point, viz: 4.40.31, the pen was driven 

above the drum. 
Three minutes later pen was returned to drum, and traced 

the third stage, viz : slight fall of pressure and rate. 



1 Experiments performed in the Physiological Laboratory of the University of Pennsylvania. 

2 The rise in the pressure was so sudden that there was not time for any increase of rate ordi 
narily seen in the second stage. 



34 



THE USE OF TOBACCO. 



These two tables show only the first and second stages. 

TABLE SHOWING PULSE KATE AND PRESSURE. 1 

The arterial pressure is expressed in millimeters. 



Time. 


Drug. 


Pulse. 


Arterial 
Pressure. 


5. 
5.10 




168 


93- 98 


5 10.01 


& drop. 






5.10.11 




72 


87-102 


5.10.21 




78 


101-117 


5.10.31 




118 


117-115 


5.10.41 




124 


115-117 


5.10.51 




150 


116-118 


5.11.01 




138 


119-122 


5.11.11 




150 


116-118 


5.11.21 




138 


120-122 



DOG No. 3. 

Non-curarized. 

Weight of dog about 30 pounds. 

Injected into Jugular vein. 

Decrease in rate showing first stage. Arterial pressure not 

being much affected in first stage, but increasing in 

second stage, along with the rate. 



TABLE SHOWING PULSE RATE AND PRESSURE. 



Time. 


Drug. 


Pulse. 


Arterial 
Pressure. 


2.15 








2.15.10 




162 


85- 88 


2.15.11 


S V drop. 






2.15.21 




142 


80- 91 


2.15.31 




124 


86- 92 


2.15.41 




110 


88- 94 


2.15.51 




142 


90- 98 


2.16.01 




120 


95-105 


2.16.11 




118 


106-108 


2.16.21 




142 


102-110 


2.16.31 




148 


104-113 


2.16.41 




148 


108-115 


2.16.51 




120 


110-117 


2.17.01 




123 


113-120 



DOG No. 4. 

Non-curarized. 

Weight of dog about 25 pounds. 

Injected into the Jugular vein. 

Slight fall of pressure showing first stage, followed by the 
fall in rate. 

Increase of pressure and rate, showing second stage. 



1 Experiments performed in the Physiological Laboratory of the University of Pennsylvania. 



centres in the medulla or the peripheral endings of the vagi or 
the ganglion of Ludwig. That the drug does not act on the 
heart muscle, etc., is proved by the experiments of Dr. Benham 
(loc. cit.) and the writer. Traube and Rosenthal both state that 
previous division of the par vagum does not prevent the slow- 
ing of the pulse rate after the administration of the Nicotine. 
This, of course, proves that the action is not centric, at least 
entirely so. 

In the experiments of Tugenhold reported by Rosenthal and 
quoted by Wood, the primary lowering of the pulse rate amounted 
almost to diastolic arrest which was not prevented by previous 
division of the par vagum, but did not occur when very large 



ACTION ON THE CIRCULATION. 35 

doses of woorara were given. As woorara in large doses pro- 
duces paralysis of the peripheral inhibitory apparatus, Rosenthal 
argues that the primary lowering of the pulse rate, ending in 
cardiac diastole often, is caused by stimulation of the peripheral 
endings of the pneumogastric. The effects of the drug, as 
already detailed, when applied directly to the heart also tend to 
prove, with the evidence already brought forward by others, that 
the action of the drug is at least largely peripheral. 1 

The question as to whether the drug affects the ganglion of 
Ludwig as well as the peripheral endings of the pneumogastric, 
is one not easily decided. The only way to decide would be 
by the use of antagonistic drugs, which is always an uncertain 
method of research. Other observers 2 have decided that large 
doses of Nicotine (about J— 1 drop) produce paralysis of the 
peripheral inhibitory apparatus, without involvement of the 
centre of Ludwig. It may be considered probable at least that 
if large doses do not affect Ludwig's ganglion small doses do 
not either, and we can be pretty safe in believing, therefore, that 
the ganglion of Ludwig is not stimulated in the primary stage 
of Nicotine's action. 

The increase of pulse rate in the second stage is probably due 
to partial paralysis of the pneumogastric peripherally. The 
reason the action is spoken of as peripheral is this : As the 
inhibitory centre in the medulla is not affected in the first stage, 
the supposition is at least permissible that it remains intact in 
the second stage. Traube also found that if the par vagum be 
cut during this stage, the pulse rate increased still more, which 
proves, first, that the centre in the medulla was still acting, and 
second, that the nerve itself was not completely paralyzed, or it 
could not have transmitted the centric impulse. 

The slowing of pulse rate which occurs with the fall of 

1 If atropia, which paralyzes the peripheral inhibitory apparatus, be given 
in this stage the pulse is immediately increased in rate. 

2 For several interesting studies as to the antagonism etc., of Atropia, 
Muscarin and Nicotine, see Schmiedeberg-Bericht der S'ache ; Academie d. 
Wissenschaften. Mail. Phys. CL, 1870, 129; also Ludwig's Arbeiten, v, 41. 



36 THE USE OF TOBACCO. 

pressure in the third stage is very slight, and is probably due 
to temporary cardiac exhaustion after the violent efforts of the 
second stage. Rosenthal also found that stimulation of the 
pueumogastrics with the strongest galvanic currents produced 
no effect on the cardiac pulsations in the third and fourth 
stages. 

From this it would appear that the paralysis of the pneumo- 
gastrics is one of a creeping character, which in the second stage 
is merely beginning, but which in the third and fourth stages is 
complete. In other words, Nicotine acts on the pneumogastric 
just as other paralyzants of the pneumogastric do, first stimu- 
lating the nerve and then paralyzing it. The rise and fall of 
the arterial pressure is probably largely due to the action, either 
directly or indirectly, of the drug on the vaso-motor system. 

The writer found that the rise of pressure was not nearly so 
great after the injection of -^ drop of Nicotine in the curarized 
dog as in the non-curarized animal. As Nicotine produces 
death by asphyxia, 1 it will be readily seen why the arterial 
pressure would be much greater in the non-curarized than in the 
curarized animal, in whom artificial respiration was kept up. 

We may, therefore, consider that the rise is partly due to 
stimulation of the vaso-motor centre by the asphyxia produced. 

The writer also found that the mesenteric capillaries of the 
frog contracted in the second stage, but became dilated in the 
third and fourth stages. 

That the vaso-motor system is really paralyzed in the later 
stages, the writer proved by producing asphyxia, which caused 
no change in the arterial pressure of the dog operated upon. 

This does not, however, prove that the centre of the vaso-motor 
system in the medulla is paralyzed, since the vaso-motor nerves 
may be so influenced as to be unable to transmit the centric 
impulse. 

The question as to what part of the vaso-motor system is 
affected in the later stages is, therefore, undecided, but that 
paralysis of some part of the system is present is certainly a fact, 
1 See Action on Respiration. 



ACTION ON THE CIRCULATION. 



37 



and the fall of arterial pressure is evidently caused by the vaso- 
motor disturbance. The fall of pressure in the primary stage 
is, of course, due to inhibition of the heart. 

Below will be found tables showing the effect of smoking on 
the pulse rate. 

Table No. 1 was taken from a person who never smokes. 1 
Table No. 2 from a person who is an inveterate smoker. 



TABLE NO. 1 * 



TABLE NO. 2.f 



DAT. 


Before 
Breakfast. 


Before 
Dinner. 


Before 
Supper. 


1st. 
2d. 


/Normal 65 

1 Abnormal 98 

/Normal 60 

1 Abnormal 97 

I Normal .63 


66 
80 
68 
83 
64 
89 
66 
87 
65 
82 


66 
90 
67 
92 
63 


3d. 
4th. 


1 Abnormal 95 

( Normal 67 

) Abnormal 98 


88 
66 
98 
64 


6th. 


\ Abnormal 94 


94 


Normal average 64 

Abnormal average 96 


66 
84 


65 
92 



Day. 


After 
Breakfast. 


After 
Dinner. 


After 
Supper. 


1st. 




Normal 67 

Abnormal 85 


66 
72 
67 
74 
64 
71 
67 
82 
65 
81 


66 

78 
68 


2d. 
3d. 
4th. 
5th. 


Abnormal 87 

'Normal 62 

Abnormal 84 

'Normal 64 

Abnormal 86 

Normal 66 

i Abnormal 84 


76 
66 
74 
64 
76 
64 
72 


Normal average 65 

Abnormal average 85 


70 
76 


66 
73 



Before 


Before 


Before 


Breakfast. 


Dinner. 


Supper. 


54 


66 


63 


72 


78 


72 


54 


60 


66 


72 


78 


60 


63 


72 


63 


81 


78 


72 


57 


72 


72 


72 


81 


72 


57 


72 


72 


72 


78 


81 


57 


68 


67 


74 


79 


73 



After 


After 


After 


Breakfast. 


Dinner. 


Supper. 


69 


57 


69 


72 


75 


69 


78 


90 


63 


78 


96 


72 


72 


81 


63 


78 


87 


72 


66 


75 


66 


78 


84 


69 


66 


69 


69 


81 


81 


78 


60 


74 


66 


77 


85 


72 



* In all cases, although the pulse rate was increased, the arterial pressure'or tension was dimin- 
ished markedly. Person is not accustomed to the effects of tobacco. These changes were caused 
by smoking, rapidly, one cigarette. 

f In all cases, although the pulse rate was increased, the arterial pressure or tension was dimin- 
ished markedly. Person is an inveterate smoker. These changes were caused by rapidly smoking 
one cigarette. This person never uses tobacco otherwise than by smoking. 

It will be seen in the preceding tables that smoking invariably 
caused increase of pulse rate, although the time of day and the 
presence of food in the stomach governed the degrees of increase 

1 See end of paper, showing tracings of pulse before and after smoking, 
as taken by the use of Marey's sphygmograph. 



38 THE USE OF TOBACCO. 

very strongly. It will also be noted that the increase of pulse 
rate was greater in the person unaccustomed to the drug than in the 
person who was a constant smoker, a result which one would expect. 
In Table No. 1 there was a greater increase before breakfast 
than at any other time of day, and in both tables the increase 
was greater in the morning than at noon or night, although in 
Table No. 2 the increase after breakfast was as great as before, 
although the normal pulse after breakfast was higher than before 
that meal. It is a rather curious thing that all through Table 
No. 2 the increase of rate after smoking was the same after 
meals as before, notwithstanding the fact that the meals always 
increased the normal rate. 

V. ACTION OF THE DRUG ON THE RESPIRATION. 

"When 3V drop of Nicotine is injected into the jugular vein 
of an animal, the respirations almost instantly become rapid and 
very deep, the chest walls being expanded to their greatest 
extent, and both inspiration and expiration are accompanied by 
a peculiar whistling or hissing sound, which is probably due to 
spasmodic contraction of the larynx, as it does not occur when 
the animal breathes through a tube in the trachea. 

The conjunctiva and the membranes of the mouth are intensely 
congested and dark. There is a very forcible up and down 
movement of the whole larynx. This lasts for a few moments 
only, when the respirations become slower than normal. The 
ordinary tracings of arterial pressure show, in the non-curarized 
animal, that asphyxia is present, by the characteristic asphyxia 
curves. That the drug produces death by depressing the respi- 
ration, has been proved by Bernard, Van Praag, Kolliker and 
Albers, and that this depression is due to centric action on the 
part of the drug is proved by the fact that the breathing is not 
changed by section of the vagi. 

All observers, with one exception, namely, Brodie, assert most 
positively that the heart continues to beat for some time after 
the respirations have ceased. 1 

1 Phila. Med. Times, May 12, 1877 ; art. by F. L. Haynes. 



ACTION ON THE BLOOD. 39 

In twenty dogs which were killed by Nicotine, in the course 
of the writer's experiments, death occurred invariably from 
stoppage of respiration ; in every case the heart pulsated some 
moments after respirations ceased. 

VI. ACTION ON THE BLOOD. 
EXAMINATION — MACROSCOPIC AND MICROSCOPIC. 

The action of Nicotine on the part of the organism con- 
sidered under this heading is twofold ; both effects, however, 
depending on entirely different modes of action. If a small 
amount of Nicotine be injected into the jugular vein of an 
animal, the blood on the arterial side of the circulation, in the 
course of a few minutes (about five) becomes equally dark in 
appearance with that on the venous side, and if the jugular be 
opened on one side of the neck and the carotid be opened on 
the other side, the observer will be unable to tell which is venous 
and which is arterial blood, except by the interrupted flow of the 
latter. That this dark hue of the arterial blood is largely de- 
pendent on the asphyxiating powers of the drug is proved by 
the fact that if shaken up with air the blood regains, to a certain 
extent, its normal arterial hue. 

The effects of the drug on the corpuscular elements of the 
blood are quite interesting. The writer found that the red 
corpuscles were always crenated, and if the amount of the poison 
was very large, partial disintegration appeared to take place. 

The corpuscles, instead of arranging themselves in rouleaux, 
formed themselves in rows, as ducks walk one behind the other, 
the edge of each corpuscle touching the edge of its predecessor. 
When the poison was added on the stage of the microscope the 
red corpuscles seemed to shrink and decrease their diameter, 
losing to a great extent their bi-concave shape and shortly be- 
coming colorless and transparent. Occasionally a corpuscle would 
seem to be spiculated, resembling somewhat a horse-chestnut, but 
with fewer spicules. 

On the white or colorless corpuscle the action of the poison is 
D 



40 THE USE OF TOBACCO. 

marked. When this corpuscle is moving on the warm stage the 
addition of Nicotine instantaneously arrests its movements and 
breaks it up into eight or more divisions or segments, which 
now and then become detached and float off by themselves. 
These divisions are round and resemble the red corpuscle con- 
siderably in shape. 

The globular form which is often assumed by the white 
corpuscle does not appear after the addition of Nicotine. On 
the contrary the movements stop, leaving the protoplasmic 
process in the position last taken and unretracted. 

EXAMINATION — SPECTROSCOPIC. 

The usefulness of the spectroscope in physiological, as well 
as other examinations, is so universally conceded that a paper 
of this character would not be complete without some spectro- 
scopic examination of the blood under the various conditions 
which are brought about by Nicotine. Before detailing the 
experiments, etc., which the writer performed with the aid of 
the spectroscope on nicotinized blood, it may be well to recall 
to the reader, very briefly, the methods by which such examina- 
tions are made. 

Any one using the spectroscope as a tyro, will find that the 
mere examination of normal haemoglobin will not impress the 
true spectra sufficiently strongly on his mind to enable him to 
distinguish changes which may take place in the poisoned or 
altered solution ; and it is therefore advisable for the beginner 
to have two glass cells, one centimetre in diameter, in one of 
which, the lower preferably, can be placed the normal standard 
solution, the upper cell being reserved for the fluid which it is 
desired to analyze. The bottoms of the cells should be made of 
thin " cover glass," such as is used in microscopic work, in order 
that the two spectra may not be too widely divided. 

The capacity of the two cells should be equal, and the glass 
of which they are made should be of the same thickness. 

The lower cell should be full enough of the liquid to allow 
the under surface of the upper cell to come in contact with the 



ACTION ON THE BLOOD. 41 

solution. The reader will pardon the writer if he adds a few 
notes which may refresh the memory in regard to haemoglobin 
and its changes of spectra, etc. 

It should be remembered that blood removed from an animal 
while living shows the spectrum of oxyhemoglobin, provided 
that the animal is not influenced by some agent or drug which 
normally is not present in his system, and that the blood be 
examined soon after death ; because blood outside the body 
becomes reduced in a few hours, even when in a tightly stop- 
pered bottle. 

Venous blood contains enough oxygen to give the spectrum 
of oxyhemoglobin, and the spectroscope will not show any differ- 
ence between arterial and venous blood while life is present. 
This is not so after death, since Dr. MacMunn has proved that 
venous blood after death gives the spectrum of reduced hemo- 
globin. 1 The same observer also found that the reduction took 
place in the act of dying, and was not the result of decomposi- 
tion. 2 If death is caused by asphyxia, however, the arterial and 
venous blood immediately after death gives the spectrum of 
reduced hemoglobin, because the tissues in such cases abstract 
the oxygen from the blood and the blood also consumes its own 
oxygen. 

It should be borne in mind that oxyhemoglobin and oxidized 
hemoglobin are one and the same thing, and that reduced 
hemoglobin, hemoglobin and deoxidized hemoglobin are also 
synonymous. 

When a strong solution of oxyhemoglobin or of freshly-drawn 
arterial or venous blood is placed before the slit in the spectro- 
scope, all light is cut off; as more water is added, the character- 
istic spectrum of oxyhemoglobin appears between the orange- 
yellow and the green, and, therefore, nearest the redward side of 
the field. If still more water be added, this solid band divides 
into two bands, of which the one next the orange-yellow is the 

1 The Spectroscope in Medicine, MacMunn, p. 71. 

2 This reduction is not seen after death from cold or starvation, owing to 
diminished reducing power of the tissues. 



42 THE USE OF TOBACCO. 

most pronounced, while the band next the green is wider, but 
more washed out. 

On diluting still more, we narrow these bands, and finally 
only the redward band is left, which, on another addition of 
water, also disappears. 

Preyer has found that a solution of oxyhemoglobin, of the 
strength of 0.08 per cent., always gives the full absorption band. 
The writer has found that blood requires a dilution of fifteen 
times to give the same spectrum. 

The spectrum of oxyhemoglobin is darkest, or as dark at 
the edges of the band as at its centre, while that of reduced 
haemoglobin is darkest in the centre and shades off lightly at 
the edges. In the reduced solution, the spectrum has its centre 
where the unreduced spectrum would, if diluted, divide. It 
also "blocks out" more of the orange-yellow than does the 
oxyhemoglobin band, and does not dim the blue side of the 
spectrum as much as the unreduced solution; as a consequence, 
the latter lets through the red and orange-yellow rays, and the 
former the red and bluish rays., 

EXPERIMENT NO. I. 

In the Lower Cell. — A solution of normal 1 (?), defibrinated 
blood of sufficient strength to show the absorption band of 
hemoglobin. 

In the Upper Cell. — The same solution, to which was added 
one drop of Nicotine. 

The changes resulting were not marked enough to be at all 
conclusive. The orange-yellow was slightly increased in width, 
and the hemoglobin band narrowed correspondingly on that 
side; the width of the absorption band being decreased by the 
encroachment of the orange-yellow. 

1 This defibrinated blood had been dried and kept in the Physiological 
Laboratory for some time. The writer could not discover whether it had 
been obtained from a normal source or not. The results, such as they are, 
are, therefore, open to the accusation of being fallacious. It is hardly 
necessary to add that the spectrum was that of reduced hsemoglobin. 



ACTION ON THE BLOOD. 43 

There was a dim lightening in the centre of the band, which 
suggested the separation of the solid band into the two bands 
which are seen when a strong solution of oxyhemoglobin is 
diluted. 

EXPERIMENT NO. II. 

In the Lower Cell. — A dilution of blood, obtained immediately 
after death, which was caused by Chloral, not for any purpose 
on the part of the writer, but in the course of an experiment 
performed by some one else. As this blood was obtained after 
death the spectrum was that of reduced hsemoglobin. 

In the Upper Cell. — The same solution, to which was added 
two drops of Nicotine. The following changes took place. The 
orange-yellow, which was slightly increased in its dimensions in 
the first experiment, was still more increased in the one before 
us. The absorption band was correspondingly narrowed on the 
red ward side as the width of the orange-yellow increased. 

EXPERIMENT NO. III. 

In the Lower Cell. — A dilution of arterial blood taken from 
a young and healthy dog before any of the Nicotine had been 
administered. 

In the Upper Cell. — A dilution of arterial blood taken from 
the same animal after the venous injection of one-half drop of 
Nicotine. 1 As usual in Nicotine poisoning the blood was darker 
than normal. The change was very marked. The band was 
divided into two bands in a manner somewhat resembling the 
division which takes place when a normal and strong solution 
of oxyhemoglobin undergoes further dilution. 

This separation differed from the almost inappreciable separa- 
tion which took place in Experiments Nos. 1 and 2. It was 
very marked and was as wide as the band is on the left of the 
observer in a oxyhemoglobin solution of about 0.09 per cent. 
Through this break appeared the light as olive-green. The 

1 The dilution in all these experiments was strong enough to give one 
broad band, undivided. 



44 THE USE OF TOBACCO. 

absorption band on the left was dim and filmy. The orange- 
yellow was widened. 

EXPERIMENT NO. IV. 

In the Lower Cell. — A dilution of normal arterial blood. 

In the Upper Cell. — A dilution of blood from the same 
animal, abstracted from the artery just before death, caused 
by one-half drop of Nicotine. The heart was still beating but 
respiration had just stopped and the blood had the characteristic 
darkened hue such as Nicotine always produces in poisonous 
doses. In this case the blood was particularly dark. 

The result was the same as in Experiment No. 3, only more 
marked, the absorption band being separated and the band on 
the left-hand side of the observer being still more filmy than 
before. 

The orange-yellow was correspondingly increased in width 
with the dissolution of the band just mentioned. 

The olive-green seen between the bands was also increased in 
width and intensity. There was no displacement of the bands 
either to the right or left side. 

EXPERIMENT NO. V. 

In the Lower Cell. — A dilution of normal arterial blood. 

In the Upper Cell. — In this cell was placed some of the blood 
of Experiment No. 3, which had been brightened in appearance 
by shaking with the air. The dark color was almost all gone. 

The result was the same as in those cases which were not 
shaken with air. 

This experiment was then performed on the still more dark- 
ened blood of Experiment No. 4, with the same result. The 
object of this shaking with air being to supply the blood with 
oxygen which it may have lost owing to the asphyxia produced 
by the poison. 

This was probably the cause of its dark hue, in part, at any 
rate, since, as already stated, the color became more arterial when 
the blood was shaken with air. 



ACTION ON THE BLOOD. 45 

EXPERIMENT NO. VI. 

In the Lower Cell. — A dilution of normal arterial blood. 

In the Upper Cell. — A dilution of blood drawn from an artery 
of a dog poisoned by one-fourth drop of Nicotine. 

The changes noted were not as marked, owing, perhaps, to the 
small amount of the dose, as in Experiments Nos. 3 and 4. 

The chief point noticed was the increase of the orange-yellow 
associated by corresponding decrease of the band of absorption, 
in the same manner as has been described in some of the experi- 
ments already detailed. The separation of the bands which was 
so marked in the other experiments was so slight and indistinct 
as to cause doubt as to its presence, although the writer could 
discover in the centre a faint shade of olive-green. Aside from 
this indistinct and uncertain change the band resembled that of 
reduced hsemoglobin in the way it shaded off at the edges. 

EXPERIMENT NO. VII. 

In the Lower Cell. — A dilution of normal arterial blood from 
a dog. 

In the Upper Cell. — A dilution of arterial blood, after the 
venous injection of one and one-half drops of Nicotine. The 
characteristic dark hue was present and was well-marked. In 
order to avoid any errors which might arise, owing to the 
asphyxia produced by the drug before death, the writer passed 
a constant stream of oxygen through the dilution, the color 
being more arterial after this procedure. When examined be- 
fore the slit in the spectroscope the spectrum was altered in the 
same manner as before. The red ward band was narrowed and 
the orange-yellow increased and there was a marked widening 
in the split in the spectrum. The edge of the red ward band on 
the orange-yellow side was not clearly outlined but filmy in 
appearance. 

EXPERIMENT NO. VIII. 

In the Lower Cell. — A dilution of the poisoned blood, showing 
the abnormal spectrum, already described. 

In the Upper Cell. — A dilution of the same blood, through 



46 THE USE OF TOBACCO. 

which a stream of oxygen was passed for about fifteen minutes. 
The two cells were filled with poisoned blood in this experiment, 
in order that the two abnormal spectra might be the more closely 
compared. Although the hue of the blood through which the 
oxygen was passed was more arterial than the other, the spectra 
were the same. 

It will be seen that in every case the orange-yellow was 
widened, which is somewhat remarkable, since the red ward band 
is normally more constant and pronounced than its fellow. 

To sum up the results of these experiments: We find that 
the most constant change produced by the Nicotine was the 
encroachment of the orange-yellow rays on the redward side of 
the absorption band. We also find that where the poison was 
in fairly large quantity, the band was divided just as a dilute 
oxyhemoglobin band would be, although the spectrum, which 
one would expect, would be that of reduced haemoglobin, owing 
to the asphyxia and the dark color of the blood. In Experi- 
ment No. 6, where the amount of the poison was very small, 
the change was not as marked as in the other experiments; 
although the redward portion of the band was decidedly en- 
croached upon, the blood was not profoundly enough affected 
to show the split in the band. The band, therefore, as before 
stated, resembled that of reduced hemoglobin, in the filmy 
outline of its edges and the lack of division in the band itself. 
The fact that the blood became more arterial in hue when 
shaken w r ith air and when oxygen was passed through it, com- 
bined with the resemblance of the spectrum in Experiment No. 
6 to that of reduced haemoglobin, would seem to prove that the 
oxyhemoglobin became reduced, either by the asphyxia which 
was present, or by some direct action of the drug on the red 
corpuscle and its contained oxyhemoglobin. When we consider 
that blood, when shaken with air, and through which oxygen 
had been passed, gave the same identical spectra as before such 
procedure took place, we must come to the conclusion that Nico- 
tine acts directly on the oxyhemoglobin, and that the probable 
reduction which takes place is due to this action, combined with 



ACTION THROUGH THE CUTANEOUS SURFACE. 47 

asphyxia. The disintegration of the red blood corpuscles, 
already noted, points to the correctness of this conclusion. 

Death, then, occurs in Nicotine poisoning, not simply from 
ordinary asphyxia, owing to depression of the respiratory centre 
in the medulla, but also by the failure of the haemoglobin to 
carry oxygen to the various portions of the body. 

VII. ON THE CUTANEOUS ABSORPTION OF NICOTINE. 

It may be interesting to quote the experiments of Dr. M. A. 
Randolph and Mr. S. G. Dixon on this part of our subject. 1 
These experiments were performed in the laboratories of the 
University of Pennsylvania. In these experiments they used 
only rabbits of ascertained good health. "The fur of the ab- 
domen was carefully clipped (not shaved), sufficient time, usually 
seven days, being allowed to intervene between this operation 
and the application of the drug to the skin, thus permitting any 
slight scratch made at this time to fully heal. The absence of 
cutaneous lesions was further confirmed by closer examination 
under a strong hand magnifier. The drug was then applied to 
the skin, no friction being used. In order to preclude the 
possibility of its vaporization and subsequent absorption by the 
lung surface, the Nicotine was placed upon an adhesive plaster, 
the backing of which was made of sheet rubber. The plaster, 
with the drug in its centre, was then applied, in the open air, on 
a windy day. Different doses were applied; thus, in one case, 
one drop of Nicotine applied to the skin caused death in five 
hours and eleven minutes. In each of three cases a similar 
application of ten drops was fatal in respectively one hundred 
and nine minutes, twenty-eight minutes and thirty-six minutes. 
In the fifth case, a similar application of fifteen drops of Nico- 
tine caused death in twenty-eight minutes." 

" Of the ante-mortem symptoms, contraction of the pupil was 

constant, and often appeared very quickly. Other prominent 

symptoms were great trembling, with subsequent loss of mus- 

1 See Proceedings of the Academy of Natural Sciences of Phila., Nov. 
11, 1884. 



48 THE USE OF TOBACCO. 

cular power in the extremities. In one case, actual convulsions 
were noted, and in others, coldness of the skin and increased 
lachrymal and nasal secretion. Immediately upon the death of 
two of the animals (after the ten and fifteen-drop doses respect- 
ively), blood was removed, defibrinated, and tested with mercuric 
chloride for the presence of Nicotine, in the manner detailed by 
Wormley (' Micro-Chemistry of Poisons'). In each of these 
two instances, characteristic groups of crystals were found upon 
microscopic examination of the extract from the blood." 

Dr. Randolph has been kind enough to send the writer micro- 
photographs of the crystals of Nicotine and mercuric chloride 
which he found in the blood after death from the cutaneous 
absorption of Nicotine. (See Plates.) 

VIII. ON THE INTESTINES. 

Nasse 1 has found that when Nicotine is injected into the 
jugular vein, a tetanic contraction of the whole intestinal tract 
takes place, and that section of the vagi or compression of the 
abdominal aorta did not affect the contraction. The splanchnics 
were unable to exercise their inhibitory influence, either because 
they were paralyzed or because the spasm was too intense for 
them. The writer also saw the tetanic contraction which was 
always accompanied by defecation. He also compressed the 
abdominal aorta, and the result was the same as above stated. 
In his experiments on the pupil the writer found that the 
sympathetic was paralyzed peripherally, and that there was 
probably an unconquerable oculo-motor contraction. The results 
before us correspond exactly with the results that have already 
been obtained, and reasoning by analogy, which is in this case 
most direct, we must come to the conclusion that Nicotine 
paralyzes inhibition everywhere, on the heart, pupil and intes- 
tines, and that it stimulates involuntary muscular fibre, as, for 
example, that of the iris and intestinal canal. 

1 Beitrage zur Phys. der Darmbewegung, Leipsic, 1866, quoted by H. C. 
Wood. 





PHOTOGRAPH, GEO. A. PIERSOL, M.D. 



PHOTOTYPE, F. GUTEKUNST. 



Compound Crystals of Nicotine and Mercuric Chloride. 

Extracted from the Blood of a Rabbit, after Cutaneous Absorption. 



ACTION THROUGH THE LIVER. 49 

IX. ON THE ACTION OF THE LIVER ON THE EFFECTS OF 

THE DRUG. 

Under the head of original communications, in the Phila. 
Med. Times for May 20th/ 1877, Dr. B. F. Lautenbach gives 
some very interesting accounts of the action of the liver on 
Nicotine. He determined that one drop of Nicotine would kill 
a large dog if injected into the general circulation. He then 
injected one drop of the poison into the mesenteric or splenic 
vein or into the small intestine, thus forcing the poison to pass 
through the liver before entering the general circulation. The 
result being that the animal recovered from the effects of the 
poison in from fifteen minutes to an hour, and appeared like a 
normal dog. He also found that even two drops of Nicotine 
fail to kill a dog when the poison first passes through the liver. 
When the drug is injected into the subcutaneous tissue in a one- 
drop dose the animal has more intense symptoms and often dies 
in one minute from the time of injection. 

Dr. Lautenbach also found that if the vena porta be tied 
trismus and tetanus were produced, and death came on rapidly, 
although the dose was but one-fifth of a drop. 2 

The experimenter also found that one-tenth drop of Nicotine 
killed frogs, of the esculenta and temporaria species, very rapidly. 

One-twentieth drop always produced severe symptoms but 
never death. 

When one-fortieth drop of the poison was given to frogs, 
whose livers were extirpated, death occurred, while in a large 
number of experiments with the normal frog "no symptoms 
whatever" were produced by the same dose. The same frogs, 
four hours later, when given the same amount as before, their 
livers being in the meantime extirpated, died, with symptoms 
exactly the same as their predecessors. . 

1 On a New Function of the Liver, page 387. 

2 The experimenter found that ligation of the vena porta caused death 
very shortly. For the symptoms which were produced I must refer the 
reader to the reference given ; the portion here quoted being but a small 
part of a very interesting paper, which will well repay any one who takes the 
trouble to look it up. 



50 THE USE OF TOBACCO. 

Hyperemia of the liver was now ingeniously produced/ in 
order to discover whether activity of that organ affected the size 
of the fatal dose. When one-tenth drop — the fatal dose for a 
normal frog — was administered " not the slightest symptom was 
observed/' nor would one-fifth drop cause death. Showing most 
conclusively that greater activity on the part of the liver pre- 
vents the poison from acting, even in large doses. In other 
words, the liver seems to destroy the poison. 

Dr. Lautenbach went still further, macerated the livers of 
dogs and rabbits with from 3-5 drops of Nicotine, and injected 
the expressed juice into dogs and frogs. The animals showed 
mild symptoms of Nicotine poisoning, but did not on any occa- 
sion die. When the juice was given to three liverless frogs they 
only showed slight symptoms. 

As counter experiments Lautenbach macerated the kidneys 
and added Nicotine, and the animals treated with this juice 
all died. 

The experimenter then draws a conclusion which is of great 
practical interest, viz. : There is no danger from the effects of 
chewing tobacco, because any Nicotine which is swallowed passes 
through the liver, while the Nicotine inhaled with smoke passes 
into the general circulation through the lungs. 

If this theory held good in practice we should find that the 
small boy, for example, would be more sick from his first smoke 
than his first chew, and this is not often the case, possibly be- 
cause of the constant contact of the drug with the mucous mem- 
brane of the mouth, where chewing is practiced. Dr. Lauten- 
bach in this paper just quoted naturally comes to the conclusion 
that the liver destroys Nicotine. In a later paper, 2 however, he 
comes to somewhat different conclusions; the reasons for his 
change of opinion being as follows : In later experiments he 
found that Nicotine, when injected into a vein of the general 

1 For method of procedure, see Phila. Med. Times. 

2 Phila. Med. Times, vol. x, No. 523. On the Difference in the Effects 
produced by Nicotine when Injected into an Efferent, from those produced 
by the introduction of the poison into an Afferent Blood Vessel. 



PATHOLOGICAL ACTION. 51 

circulation, produced death in the rabbit in a half-drop dose, 
while if three-quarters of a drop was injected into the femoral 
artery of an animal of the same species there resulted, not death, 
but only poisonous symptoms, and the animals recovered in less 
than two hours. 

When he injected one-half drop of the poison into the carotids 
of cats convulsions were produced, but not death. These experi- 
ments appear to prove that it is only necessary for Nicotine to 
pass through a series of capillaries to be deprived of its poison- 
ous properties and the liver has no specific effect of its own. 
The whole line of evidence is so contradictory that it is some- 
what difficult to arrive at a correct or satisfactory conclusion. 

When the drug was injected into the femoral artery, we can 
readily understand that its action would be slower and more 
dispersed than when injected into a vein by which it would be 
sent directly to the heart and other vital points. 

The passage of the poison would be delayed, and, instead of 
rushing en masse on the vulnerable points, would attack them 
in such small detachments that the animal would survive. 

The results of the injection of the poison into the carotids of 
cats are not to be compared to those obtained by the experimenter 
with other animals, since cats are notorious for their tenacity of 
life, while rabbits are quite the contrary. 

The fact that the capillaries often rob a poison of its toxic 
properties is well known among physiologists, and Lautenbach's 
statements in this respect are by no means new. 



PART FOURTH. 



PATHOLOGICAL ACTION OF TOBACCO AND 
ITS ALKALOID, NICOTINE. 

Every smoker, almost, remembers the effects produced by his 
first use of tobacco, and, if he used it in large quantities the first 
time, he must also remember the horrible nausea, and perhaps 



52 THE USE OF TOBACCO. 

vomiting, from which he suffered. He will probably remember 
the giddiness and general relaxation which came on, and per- 
haps he had a sensation bordering on that of suffocation. Be 
this as it may, the writer thinks he is safe in asserting that every 
smoker has, at least, suffered some pang, either great or small, 
after his first use of tobacco, when he has used the drug in the 
form of smoke. When the drug is "chewed" for the first time, 
the symptoms are more apt to be severe than when it is smoked. 
The reasons for this are, that the novice is very apt to swallow 
more or less of the saliva which has been poured out, and which 
he has saturated with the various properties of the tobacco. 
Besides this, much of the drug must be absorbed by the mucous 
membrane of the mouth. When small quantities are swallowed, 
the symptoms resemble those produced by smoking, but if the 
amount has been larger, a very serious train of symptoms arise, 
which are very apt to end fatally, unless relief is obtained. 
There is faintness, vomiting, burning in the stomach, purging, 
increased flow of urine, as regards quantity, and also, often, 
incontinence of urine and of the faeces. The pulse is rapid and 
running, and almost imperceptible, even in the larger vessels of 
the extremities. There are cramps in the limbs, followed by loss 
of muscular power; the sufferer is covered by a cold, clammy 
sweat; delirium soon sets in, which is followed by collapse, 
ending in death, due to failure of respiration. 

The action of the pure alkaloid Nicotine is identical with that 
of the whole drug, except that its results are more rapidly 
reached, owing to the poison being perfectly free to act as soon 
as ingested. In cases of poisoning by either the drug or its 
alkaloid, Nicotine, the prognosis is more favorable if the patient 
vomits. This is a good sign, because, by vomiting, the patient 
rids himself of a portion of the poison, and also because it proves 
that his system is not so absolutely overcome by the poison as to 
prevent its attempting to throw off the offending agent. Vom- 
iting in such cases is of use in an indirect way, as having a 
tendency to prevent the patient falling into a soporose condition, 
in which he is liable to die from failure of respiration, while if 



PATHOLOGICAL ACTION. 53 

he be awake, he can aid respiration by his will power. Some- 
times there are clonic spasms, which do not occur when the case 
is rapidly fatal. 

Dworzak and Heinrich, 1 associates of Schroff, and also Heil, 
made several experiments with Nicotine on their own persons. 
The doses they used varied in amount from 3V drop to T V drop 
in one drachm of water. The smallest doses occasioned a 
burning sensation in the tongue, a hot, acrid irritation in the 
fauces, and when doses somewhat larger were used, the entire 
length of the oesophagus felt as if it had been scraped by an 
iron instrument. A sense of heat diffused itself from the 
stomach to the finger tips, accompanied by general excitement. 
Still smaller doses occasioned headache, and a sensation as of an 
aura in the upper jaw. Larger doses implicated the brain, 
causing torpor, giddiness and sleepiness; indistinct vision, which 
was nevertheless attended with unusual sensibility of the eye 
to light; imperfect hearing, a feeling as if the ears were stuffed 
with cotton; laborious and rapid respiration, and dryness of the 
throat. In forty minutes after larger doses, a sense of unwonted 
debility and weariness came on, the head could scarcely be held 
erect, the face became pale and the facial muscles relaxed, the 
limbs became icy cold. This coldness advanced toward the 
trunk, and faintness came on, with commencing insensibility and 
loss of consciousness. There were unpleasant feelings in the 
stomach, with eructations, nausea and vomiting, the last pro- 
ducing some relief. The abdomen was distended, and the bowels 
were the seat of disagreeable feelings. During this time there 
was an earnest desire to go to stool, and the expulsion of flatus 
and of some urine produced great relief. This relief did not, 
however, last long. One of the experimenters was attacked 
during the first half of the second hour with peculiar clonic 
spasms of the whole body, which increased in violence during 
forty minutes, and lasted for an hour. The spasms began by a 
tremulous movement of the limbs, and gradually extended over 
the whole muscular system, chiefly affecting the muscles of 
1 Mat. Med. du rein. chem. Pflanzenstoffe, p. 234, quoted by Stille. 



54 THE USE OF TOBACCO. 

respiration. There was oppression and gasping, every respi- 
ratory movement being composed of a number of short and 
incomplete inspirations. The other experimenter, during this 
time and at this period of the operation, was affected with 
unusual muscular relaxation, very laborious breathing, and a 
rigor. In other respects his symptoms were the same. Both 
persons, on their return home, felt extremely weak, walked with 
uncertain steps, and were very chilly; one of them had a return 
of the spasms and a frequent desire to urinate, which, when 
gratified, resulted in a copious 1 discharge. The following night 
both were restless and almost sleepless, and the next day were 
still unwell, unable to apply the mind, tired, sleepy, and without 
appetite. The pulse continued weak and irregular, and three 
days elapsed before the effects were entirely dissipated. 

There is one point which the writer forgot to mention when 
describing the symptoms of Nicotine poisoning, namely, the 
protrusion of the eyeball and the drawing up of the same, in a 
spasmodic manner, toward the outward corner of the orbit. 
This is so great, sometimes, as to hide nearly the whole cornea. 

The post-mortem changes, after Nicotine has been the lethal 
agent, are — great congestion of the various viscera, a peculiar 
congestion and ecchymosis of the skin, congestion of the con- 
junctiva, brain and membranes. The heart is found relaxed 
and flabby, and the right side full of blood. The liver is 
congested, and the lungs are almost black in color, so great 
is their congestion. This congestion is due to the death by 
asphyxia. 

In the frog, just before death, there is a convulsive drawing 
up of the hind legs over the back, and the fore legs are drawn 
close to the sides and toward the hind legs. This condition is 
present after death, unless the batrachian be disturbed. That 

1 Although the drug was given in almost a poisonous dose, and, therefore, 
the result can hardly be called proof of the general action of tobacco in 
increasing the quantity of urine or the reverse, it seems to the writer that 
this, at least, favors the assertion made near the beginning of the article, 
that tobacco does increase diuresis. 



PATHOLOGICAL ACTION. 55 

is to say, the frog dies in that position and resting entirely on 
his belly. 

Nicotine, notwithstanding its great toxic powers, has been 
used very rarely as a tool for murder or suicide, probably 
because it has been difficult to obtain it, and also on account of 
the general ignorance in regard to its poisonous action. The 
celebrated case of Count Bocarme figures almost as an unique 
occasion on which it was used to commit murder. This case 
occurred in Belgium, in 1851, the murderer being the Count, 
who was tried, convicted and executed, for the murder of his 
brother by forcing the poison down the latter's throat. 1 

So far as the writer can find, there have been but two cases of 
suicide produced by the alkaloid, one of which is reported by 
Mr. Taylor, and the other case occurred at Cherbourg, in 1859. 
While so few cases of a criminal nature have been due to Nico- 
tine, literature on the subject abounds with any number of cases 
of poisoning, either partial or complete, where accident or ignor- 
ance were the exciting cause. 2 The writer once saw a case of 
this kind while traveling on a train in the West. A child, about 
two years of age, belonging to the family of an emigrant, suc- 
ceeded, while the parents' attention was diverted, in obtaining a 
plug of strong chewing tobacco, and had swallowed quite a large 
piece before it was discovered. The child did not vomit at all, 
but seemed to succumb immediately to the poison. The face 
grew pale and drawn, then clammy to the touch and relaxed. 
Soon after, the whole body became limp and powerless. The 
pulse grew rapid and feeble, and the child seemed to be at death's 
door. There were no convulsions or spasms, but there was 
forcible ejaculation of urine. The party left the train soon after, 
and the writer does not know whether there was a fatal ending 
or not. 

Dr. W. J. Tyrrell, of Ohio, reports the case of a healthy little 
girl who, three weeks previously, fell against a stove and burned 

1 Annales d' Hygiene, 1861, ii. 

2 The writer means here to include those cases due to tobacco itself, as 
well as its alkaloid. 

E 



56 THE USE OF TOBACCO. 

and bruised her lip. The mother placed the oil out of the stem 
of a pipe on the lip, to heal it. The child died in the course of 
a few hours, in violent convulsions. 

Husemann states that no less than ten fatal cases have resulted 
from the use of tobacco enemata alone. 1 Dr. Tavignot records 
a case where fifteen grains of tobacco were given to a robust man 
of fifty-five, as an enema, with a fatal result. 2 Dr. Copland has 
seen a clyster containing half a drachm produce death. 3 Stills, 
also, mentions a case in which a strong infusiou of tobacco, 
given as an enema for tapeworm, caused death immediately. 
In another . case, the same result took place in about fifteen 
minutes, and in a third, in three-quarters of an hour. Mr. 
Skae reports a case in which a man swallowed a large mouthful 
of tobacco by mistake. He suddenly became insensible, motion- 
less and relaxed, with contracted pupils and a scarcely perceptible 
pulse. After these symptoms came loud cries, and dilated 
pupils, active vomiting and purging. Death, from syncope, 
finally occurred. 

The Lancet for March, 1879, p. 296, contains an interesting 
account of a case of tobacco poisoning, which is here quoted : — 

A woman, aged forty, suffering from varicose veins in the 
leg, struck her leg against a sewing machine. A severe hemor- 
rhage followed, and she attempted to control it by a tight band- 
age, under which she placed some tobacco. In three-quarters of 
an hour she appeared dangerously ill, and Dr. O'Neil was called 
in. He found her prostrated and with all the symptoms of 
tobacco poisoning, which have been so often repeated that the 
writer does not think it worth while to burden the reader by 
again mentioning them. 

It was not until Dr. O'Neil removed the bandage that he 
found the cause of the symptoms. He then washed the wound 
free of the drug, administered stimulants, and the woman re- 
covered. 

1 Handbuch der Toxicologie, vol ii, p. 483 ; quoted by H. C. Wood. 

2 Still^'s Therap., Mat. Med., vol. ii, p. 377. 

3 Diet, of Pract. Med. ; art. "Colic." 



PATHOLOGICAL ACTION. 57 

A smuggler, 1 desiring to escape the customs, covered himself 
from head to foot with tobacco leaf, which, being dampened by 
perspiration, almost caused his death, by the absorption of the 
poison through the skin. 

An American writer states that soldiers during the war of 
1812, when on hard service on the Canadian frontier, frequently 
disabled themselves for duty by applying a wet leaf of tobacco 
to the armpit. 2 

A man suffering from piles was advised to sit on a chamber, 
in which was half an ounce of tobacco and some hot coals. 3 
After a few moments he fell to the floor, without any sign of 
life except a deep sigh, every fifteen or twenty seconds. 

Three children had their heads rubbed with an ointment of 
tobacco. They were suddenly attacked by vertigo, excessive 
vomiting, fainting and sweating, and for twenty-four hours 
staggered about like drunken men. Another case, corresponding 
somewhat to this, is reported by Dr. Truchess, in which some 
snuff was put on a girl's head for the cure of tinea favosa. In 
eight or ten hours symptoms of poisoning came on, and the child 
just escaped death. 

A man and his wife were troubled with itch, and, for the 
purpose of curing the same, rubbed themselves from head to 
foot with a decoction of tobacco; dangerous and alarming symp- 
toms soon came on, and they were saved, with difficulty, from 
death. 

Murray gives an account of a young man who smoked twenty 
pipes of tobacco, on a wager, and then fell into a lethargic con- 
dition ; and also an account of two brothers, one of whom smoked 
seventeen and the other eighteen pipes of tobacco, which caused 
death in a manner resembling apoplexy. 

A case is related by Marchant, of a smoker who accidentally 
dislodged a piece of inspissated tobacco juice from his pipe, 

1 Stille, Therapeutics and Mat. Med., vol. ii, p. 374. 

2 An Essay on the Influence of Tobacco on Life and Health. By R. D. 
Mussey, m.d. Boston, 1836. 

3 Am. Jour. Med. Sci., Jan., 1847. 



58 THE USE OF TOBACCO. 

which he swallowed. Soon afterward, the man fell down 
insensible, and would have died if assistance had not been 
rendered. 1 

Ramazzini saw a girl present all the symptoms of tobacco 
poisoning and discharge blood from the bowels, from being too 
long among tobacco bales. Fourcoy states the case of a man 
who died in convulsions from the same cause. 

It has been claimed, with only partial truth, that many very 
serious disorders, not only functional, but also organic, arise 
from the use of tobacco in any form. The assertions of the 
older writers. are, that cancer is one of the most frequent results 
of smoking or chewing tobacco, that is, among those diseases 
which are classed as organic. These cases of tobacco cancer, if 
the writer can use such a term, are generally connected with 
some part of the mouth ; at least, the writer can find no record 
of any case of cancer occurring elsewhere when caused by tobacco 
excess. The word "excess" is used here, not in its generally 
accepted sense, of intemperance, but in the sense that any luxury 
which causes pathological effects, be the dose large or small, is 
in excess of what the smoker, etc.. should use. While the older 
writers generally believed that cancer of the mouth was caused 
directly by the tobacco, modern authors rather regard the pipe 
stem as the offending party. 

Mr. Lizars, one of the most vehement of anti-tobacco writers, 
mentions several cases, occurring in his own practice, of carcinoma 
involving the whole mouth, 2 in distinction from the form occur- 
ring solely in the lip. He also quotes numerous other cases from 
the practice of Mr. Solly and others, of the same character. Many 
of them occurred in those persons who smoked nothing but cigars, 
or, rather, never used a pipe. Thus, he reports the case of an 
East Indian sea captain, whose velum, pharynx, tonsils and left 
cheek were carcinomatous, who always smoked cheroots, and 
Mr. Lizars attributes all this to the use of tobacco in this form. 
With the exception of the cases quoted by Mr. Lizars, the writer 

1 Brit and For. Med.-Chir. Review, April, 1866, p. 543. 

2 The Use and Abuse of Tobacco. Edinburgh, 1859. 



PATHOLOGICAL ACTION. 59 

can find no record of such cases reported by other writers. 
Many surgeons in this country go so far as to state that the 
disease never appears after the use of tobacco, unless the tobacco 
be used in a pipe; 1 while others think that tobacco cancer is due 
to the pipe and the tobacco combined. To the writer, the latter 
opinion seems the most moderate and probable. So far as the 
writer can discover, no case of carcinoma of the mouth has been 
reported in this country as resulting from the use of tobacco, 2 
while epithelioma of the lip is almost daily met with, arising 
from this cause. 

A paper of this kind is not a suitable place for a discussion as 
to the pathology of cancer in regard to the hereditary tendency 
or local origin theories, but it is suitable that the question of 
carcinoma 3 of the lip and its causes should be considered. Prof. 
D. Hayes Agnew says, in regard to the causes of epithelioma of 
the lip: — " Little importance is to be attached to the alleged 
influence of the clay pipe used in smoking as a cause of this 
affection, since the number of cases, as compared with the number 
of smokers, is too insignificant to give the least credibility to this 
view. It must not be overlooked, however, that the lower lip 
is much more exposed to irritation from a variety of causes than 
the upper lip, and this fact may play no inconsiderable part in 
the causation of the disease/ 74 The same author, however, in 
speaking of the causes of cancer simply as regards its pathology, 
and reviewing the so-called "inflammatory," emotional and 
hereditary theories, says: 5 — "The inflammatory theory, which 
has already been noticed as a cause of carcinoma, is again at- 
tracting no small degree of attention, and it is highly plausible 
that a process of this nature, or any local irritation, may be 
actively concerned in inducing the disease. Cancer of the lip, 

1 In other words, attributing the entire fault to the pipe stem itself. 

2 Since writing this, the whole country has been grieved and distressed by 
the progress of just such a case, in the person of General Grant. 

3 Carcinoma and epithelioma are used synonymously. 

4 The Principles and Practice of Surgery, by D. Hayes Agnew, m.d., 
ll.d., vol. ii, p. 894. 

5 Agnew's Surgery, vol. iii, p. 656 



60 THE USE OF TOBACCO. 

no doubt properly referred to the irritation of the clay pipe in 
smokers, is an example in point, as females rarely suffer from 
the disease in this locality. Yet carcinoma occurring in this way 
by no means establishes the local origin of the disease; rather 
the reverse, as epithelioma of the lip, compared with the number 
of pipe smokers, is exceedingly uncommon, and this very fact 
would seem to imply that without some predisposition of a 
general character, the local irritation would be powerless to evoke 
the disease." A little further on, the author quoted says: — 
"Epithelioma is more frequently observed in males than in 
females. It is stated by Dr. Marsden, that of 1467 cases of 
cancer admitted into the Cancer Hospital in London, 1022 were 
males. Koch, in an analysis of 145 cases, found 132 in males 
and 13 in females." Dr. Partsch, 1 in analyzing 570 cases of 
epithelioma, finds that of this number 98 were on the lips, 88 of 
which were in males and 10 in females. He also asserts that 
tobacco smoking had little influence in their production, most of 
them originating in a wound. On page 658, 2 Dr. Agnew again 
says: — "That much importance is justly attached to local irri- 
tation as a cause of the disease, as the contact of the clay pipe 
or a sharp tooth in carcinoma of the lip and the tongue." Dr. 
Ashhurst says, 3 speaking of epithelioma : — " Inheritance is rarely 
traceable in this form of the disease, while a large proportion, 
probably a majority, of cases appear to have originated from a 
local cause or injury. Thus, epithelioma of the lower lip is often 
attributable to the habit of smoking a short pipe; in the tongue, 
the disease may originate from the irritation caused by an uneven 
tooth." Prof. Louis Duhriug, 4 speaking of the same disease, 
says: — "The exciting causes are often obscure. The disease is 
apt to have its starting point in a locally irritated tissue, as, for 
example, in an excoriation, or about a lip that had been irritated 
by the use of the pipe, or through uncleanliness." 

1 Phila. Med. Times, April 4, '85. Transactions. 

2 Agnew' s Surgery, yol. iii. 

3 The Principles and Practice of Surgery, p. 506. 

4 Diseases of the Skin, 3d ed., p. 552. 



PATHOLOGICAL ACTION. 61 

Butlin says: — "The habit of smoking undoubtedly predisposes 
to the formation of epithelioma of the lip, and it is a remarkable 
circumstance that more than one of the few women who have 
suffered from this disease have been habitual smokers." 1 

Prof. S. D. Gross mentions the use of a pipe as a possible 
exciting cause of epithelioma of the lip. 

Although some of the opinions expressed on one or two 
occasions, by the various writers, have not been as clear or 
decisive as might be desired, still the mass of opinion favors the 
conclusion that epithelioma of the lip may be caused by the use 
of a pipe in smoking, and this conclusion does not interfere with 
any of the theories concerning the formation of cancers. These 
theories do, however, interfere with the conclusions which one 
w r ould like to draw, very seriously. If cancer is likely to occur 
only in those who have a hereditary tendency or diathesis, then 
the danger of using a pipe in smoking is almost necessarily 
confined to this class. 

On the other hand, if the inflammatory theory is true, the 
danger from the tobacco pipe is one to which every pipe smoker 
is exposed. 

Be this as it may, it is evident that many circu instances are 
present when a pipe is used which would prepare a good field 
for the malignant growth to start in. First, the pipe stem, which, 
by its pressure on the lip, tends to stimulate the formation of 
new epithelial cells; second, the fact that the saliva naturally 
has a tendency to flow over the most depressed portion of the 
lip which is depressed by the weight of the pipe; third, that this 
saliva macerates the tissues around the pipe, thus enabling the 
stem to irritate the lip without great motion or force; and on 
top of all this what might be called "fertilizing," if the writer 
can use such a term, comes the irritating smoke, containing the 
sulphide and cyanide of ammonium, and the still more harmful 
and acrid Nicotine. The saliva, too, while causing the macera- 

1 International Ency. of Surg., art. "Tumors," by Henry Trentkam 
Butlin, f.r.c.s. 



62 THE USE OF TOBACCO. 

tion, contains a certain amount of the Nicotine, which has been 
precipitated by losing its heat. 

Many men, too, who smoke a pipe, chew; and thus you have 
about as constant a source of irritation and maceration as can 
well be imagined. When we consider all these predisposing 
causes to cancer, we can hardly help believing that cancer of the 
lip would be far more common among pipe smokers if the 
inflammatory theory of the disease was entirely true, and there 
was no cancer diathesis to be a factor in the formation of the 
affection. Whatever may be the real danger of using a pipe for 
smoking, it certainly seems probable, at least, that the danger of 
cancer of the lip is not so great when the cigar or cigarette be 
used, although other dangers may exist, due to greater quantities 
of Nicotine being inhaled in the latter case than in the former. 
There is one danger which those who use a pipe may be exposed 
to, namely, syphilis. 

Although the transfer of the pipe from one person to the 
other, while smoking, is more eommon among the lower classes 
than among the upper, it is not an infrequent thing to see one 
man using another man's pipe; and particularly is this so among 
men in colleges and clubs. Why is it not possible to be inocu- 
lated with syphilis by putting your lips to the same mouthpiece 
which another man with mucous patches in his throat has had in 
his mouth? Why should not the second smoker, by the suction 
required in smoking, draw into his mouth some of the saliva 
which his predecessor allowed to escape into the pipe stem? 
This subject has been written on quite extensively by Prof. 
Sigmund, of Vienna, but the writer has been unable to find the 
original paper. 

Mr. Lizars, speaking of this subject, says: — "I have been 
often consulted by gentlemen having syphilitic sore throat which 
they could not account for, having had no primary symptoms 1 
on the genitals. On interrogating them, they have admitted 
using a pipe of another, or having accepted a puff of a friend's 

1 Loc. cit. 



PATHOLOGICAL ACTION. 63 

cigar. Some patients have presented themselves with syphilitic 
ulceration on the lower or upper lip, or the commissure between 
them having a thickened base. Some have had syphilitic ulcers 
of the mucous membrane of the cheeks, tongue and tonsils." 

When we consider how widespread this disease is, affecting 
all classes, we can but wonder that more cases of the kind just 
mentioned are not reported. Very few cases are recorded, com- 
paratively, of persons who have the " initial lesion" on the lip, 
or elsewhere than the genitals; 1 and it seems to the writer that 
in cases where no history of, illicit intercourse or like exposure 
to syphilis can be discovered, it would be well to question the 
patient as to his habits as regards smoking another's pipe, or 
taking a chew from a borrowed plug of tobacco. If this plan 
were carried out, w r ould not many obscure histories of syphilis 
be made clear and the patient's denial of illicit intercourse be 
accepted as a truthful statement? It has been claimed that 
angina pectoris is a frequent result of excessive smoking. It is 
probable that smoking only brings on this condition when the 
person is one of a nervous temperament, and thereby easily falls 
a victim to the nerve-disordering drug. 

Dr. Corson, in the half-yearly abstract of the Medical Sciences 
for the first six months of 1854, records a case of this kind, and 
also reports the entire cure after the withdrawal of the "weed." 
The disease is one which, of itself, is quite rare, and must be 
seldom the result of tobacco. Many of the text-books do not 
mention tobacco as a cause, at all, of this disease. 

Passing on to minor troubles, we find that almost every con- 
stant smoker suffers from catarrh of the nasal passages, or else 
pharyngitis. Frequently the smoker complains of a constant 
tendency to hoarseness on the slightest exposure; in other 
words, he suffers from chronic laryngitis. Ophthalmia and 
amaurosis are frequently seen in the smoker, and the well- 
known ophthalmologist, Sichel, held the opinion that few 
persons smoking five drachms of tobacco a day for a long period 

1 See Report of Ten Cases of Extra- Genital Chancre, with Remarks. 
Phila. Med. Times, Nov. 1, 1884. 



64 THE USE OF TOBACCO. 

escaped from diminution of vision. The opinion of Sichel 
is not coincided with by all other writers, however. Ophthal- 
mologists on the Continent do not believe in tobacco amaurosis, 
while Crichett and Hutchinson, with others, firmly believe in 
the disease, regarding the condition as one form of atrophy of 
the optic nerve. While the subject of tobacco amaurosis may 
be one of dispute, it certainly is a fact that failure of vision, 
characterized by an indistinct view of objects, is often seen in 
those who are intemperate smokers or drinkers. In such cases 
as those first mentioned, the ophthalmoscope shows nothing but 
undue vascularity and slight opacity of the optic disk. 

The most common effects of smoking; and chewing are seen in 
those cases of cardiac palpitation, or " tobacco heart," as it is some- 
times called, and also in those persons using the drug for chew- 
ing who suffer from a variety of chronic indigestion. 

It is probable that the palpitation is brought about, not by 
a direct action of the drug on the heart, but by a condition 
of nervous irritability, which may only affect the nervous 
system in that region, to all appearances, although the rest 
of the nerves are really involved. Of course, indigestion can 
be brought about by smoking as well as chewing, by de- 
pressing the nervous system. The habit of chewing, however, 
affects the digestion much more directly. It causes an undue 
pouring out of saliva into the mouth, which is either swallowed 
as a saturated solution of tobacco or ejected, and as a conse- 
quence the food, when masticated, is deprived of its ptyalin, to 
a certain extent, as well as the complete moistening which is so 
necessary to perfect digestion. The drug comes in direct contact 
with the mucous membrane, which absorbs substances with great 
ease, and if the saliva, as before stated, be swallowed, the man 
virtually takes poison into his stomach all the time. Darwin, 
in his "Zoonoinia," vol. ii, p. 701, says: — "The unwise custom 
of smoking and chewing tobacco for many hours a day, not only 
injures the salivary glands, producing dryness of the mouth when 
this drug is used, but I suspect that it also produces scirrhus of 
the pancreas. The use of tobacco in this immoderate degree 



PATHOLOGICAL ACTION. 65 

injures the powers of digestion, by occasioning the patient to 
spit out that saliva which he ought to swallow, and hence pro- 
duces that flatulency which the vulgar often take it to prevent." 

As far back as 1622 Mourach, the Sultan, prohibited the use 
of tobacco, on the score of its anaphrodisiac effects. Mr. Solly, 
the well-known surgeon, says, in the London Lancet of February 
14th, 1857, that tobacco, when used immoderately, extinguishes 
the sexual appetite, and annihilates the reproductive power. He 
thinks it is a frequent source of " spermatorrhoea," and goes on to 
say that in one week he had been consulted by three young men 
suffering from seminal weakness, and that in each case he could 
trace the trouble to the use of tobacco. It is probable that in 
all such cases as those just mentioned, the lack of power and the 
so-called spermatorrhoea are the result, not of the drug's use 
directly, but rather of the condition of nervous irritability 
and depression of the vital forces brought about by excessive 
smoking or chewing. 

If all the diseases mentioned be grouped in the reader's mind, 
and if he will go still further, and regard carefully the accounts 
of cases spoken of, even by anti-tobacco writers, the writer is 
confident that the following points will be observed : — 

First, that in all cases where evil results of any consequence 
came about, the drug had been "always" used in "excess" or 
" immoderately" 

Second, that these serious cases, when they did appear, were 
exceedingly rare and far apart. 

Third, that most of the cases reported were put on record at 
a time when anti-tobacco feeling ran very high ; and although 
the writer does not doubt that in every case the diagnosis was 
correct, it at least seems probable that cases were reported as the 
result of smoking, etc., which were really due to other causes. 

There are certain troubles, however, which really do follow the 
use of large quantities of tobacco, and although they have 
already been mentioned, it may not be out of place to bring 
them once more before the reader. 

They consist chiefly in dryness of the throat, indigestion, 



66 THE USE OF TOBACCO. 

laryngitis and pharyngitis and nervous irritability. The latter 
trouble manifests itself in various ways, according to the tempera- 
ment of the person. Of course, the chief method of cure in 
such cases is the prohibition of tobacco in any form. 

When we consider the vast number of the human race who 
use tobacco, and the enormous quantity 1 which they consume, we 
can hardly avoid coming to the same conclusion as Dr. Anstie, 2 
that while the use of tobacco is in some cases highly injurious, 
in others it has very little effect. To the young, especially, 
tobacco is a perfect curse, stunting their development, injuring 
irreparably their general physique and growth, and often entirely 
altering their dispositions by bringing on a state of constant irrita- 
bility. Its use is to be condemned in those of a sanguine or 
nervous temperament, and to be at least "winked at" if not 
approved of, in those whose temperament is more phlegmatic and 
less easily disturbed. The writer even goes further than this, and 
asserts that to the aged, who by long use have become accustomed 
to the drug, it is an actual necessity, for health or happi- 
ness. Withdraw for one day the accustomed smokes of an old 
man, and see how miserable he becomes. This is not entirely a 
feeling brought about by mental desire for the drug, but because 
his system must have its accustomed dose of tobacco. The 
writer knows an old man, personally, who after being out for a 
few hours will come in to his house, pale, feeble and exhausted ; 
so nervous, too, that he can hardly articulate, but who becomes 
quiet and comfortable after a few draws at his well-beloved pipe. 
To the laborer or the man whose avocation keeps him out of 
doors, it is probable that tobacco rarely does harm, and in cases 
of great physical fatigue is often of use, calming the restlessness 
so often present after a hard day's tramp in the open air. 

To the man of business, who is confined to an office and desk 
all day, to the hard student or the sickly, tobacco is decidedly 
harmful, and although the student often smokes with the idea 

1 For some interesting tables in regard to the amounts of tobacco pro- 
duced, its average value, etc., see Appendix. 

2 Stimulants and Narcotics. 



PATHOLOGICAL ACTION. 67 

of inducing sleep, he seldom obtains it, unless in a form of 
stupor, which does not resemble the hypnotic effects of a good, 
brisk walk before going to bed. Willis, in his " Practice of 
Physic," written just two hundred years ago, in 1684, says of 
the hypnotic powers of tobacco: — "It doth not only procure sleep 
alone, but sometimes, also, the contrary of sleep, which is watch- 
fulness." After all, the whole question of tobacco use depends 
upon the quantity consumed, and the user of tobacco must gauge 
his use of the "weed," not by the amount which another man 
can stand without harm, but by the power which he finds the 
drug can exercise in his own person. Moderation is not the use 
of a small quantity of tobacco, but the use of such a small 
quantity that its results are not serious. 

It is the argument of many, that it is impossible for one to 
grow so accustomed to the action of a drug containing such a 
powerful alkaloid as Nicotine without harm. 

To these the writer replies, that the human race can become 
habituated to any poison, never mind how deadly, provided it 
be given in moderate quantities. The Styrian peasant can devour 
enough arsenic, without other than good results, to kill several 
ordinary Europeans. The opium eater can consume enough 
opium to narcotize several average men. Haschisch, or Can- 
nabis Indica, is used by the Eastern nations most extensively. 

To this evidence the argumentative reader will say, that the 
evil effects of opium and haschisch are notorious, and that by 
mentioning them for the purpose of maintaining that the use of 
tobacco, by analogy, is not harmful, the writer has made an 
egregious mistake. 

To this he replies: — Certainly opium and haschisch, and to- 
bacco, too, for that matter, are capable of producing great evils 
if they are used in excess, but not if moderation, of a strict type, 
be adhered to. After all, tobacco is only one of the numerous 
luxuries with which mankind enjoy themselves, and coffee and 
tea have probably produced an equal number of victims. 

Caffein, the active principle of coffee, is capable of producing 
very serious toxic effects if given in large doses, and is a drug 



68 THE USE OF TOBACCO. 

which stimulates the heart and disorders the nervous system 
far more frequently than the coffee drinker dreams of. It pro- 
duces undue mental activity when such activity is not desired. 
If this mental activity be increased by additional doses of the 
drug, the patient will pass into a form of delirium. An eminent 
writer on therapeutics expresses so exactly, in writing on caffein, 
what the writer desires to express with regard to tobacco, that 
the liberty is taken of copying his words verbatim: — 

"The enormous use made by mankind of substances containing 
caffein, indicates that in some way it is directly of service in the 
wear and tear of daily life. It is not probable that any of the 
caffein is assimilated, but it may be considered established that 
it checks very greatly the elimination of nitrogen, or, in other 
words, lessens the waste of tissue." 

On the same ground, the writer considers that the enormous 
use of tobacco is also produced by the instinctive desire for some 
article which will retard tissue waste. Indeed, all drugs which 
prevent the excretion of nitrogenous material have been sought 
after, since the earliest history of man, and we can be pretty sure 
that a drug which is used everywhere and by everybody is one 
which helps a man to stand the jar and worry of business or other 
pursuits. 

Tobacco, coffee, alcohol, all retard tissue waste, and, therefore, 
men, women and children long for them, and, from using them 
instinctively and for a purpose, they soon use them in excess and 
as a luxury. Dr. McPherson, 1 quoted by Stills, testifies in re- 
gard to the use of opium in moderation, as follows, and, as he 
mentions the use of tobacco, it may be permissible to bring his 
words before the readers of this paper: — 

"Were we," he remarks, "to be led away by the popular 
opinion that the habitual use of opium injures the health and 
shortens life, we should expect to find the Chinese a shriveled, 
and emaciated and idiotic race. On the contrary, although the 
habit of opium smoking is universal, amongst the rich and poor, 
we find them to be a powerful, muscular, and athletic people, 

1 "Two Years in China;" quoted in Bell's Bull, of Med. Sci., 1843. 



ACTION ON ANIMALS. 69 

and the lower orders more intelligent, and far superior in 
mental acquirements to those of corresponding rank in our own 
country." 

M The opinion of the Chinese regarding opium is very much 
like that of many in our country regarding tobacco, and proves 
that it would be as unfair to deduce the effects of opium eating 
or opium smoking from those produced by the drug in medicinal 
doses upon persons unaccustomed to its use, as it would be to 
expect, from the habit of chewing or smoking, the violent and 
even poisonous effects which tobacco sometimes produces when 
administered by the rectum, in cases of strangulated hernia, or 
when first ventured on by boys who imagine that it is manly to 
ape the vices of men." 

ACTION ON ANIMALS. 

Schubarth made twenty experiments upon the horse, 1 giving 
four ounces of powdered tobacco to each animal, and found that 
the pulse-rate was decreased from thirty-seven to twenty-seven 
per minute, and that this depression lasted twenty-four hours. 
Sir Benjamin Brodie 2 found that an infusion of tobacco, (the 
amount not stated) injected into the rectum of dogs, caused the 
animals to become insensible, motionless, and all died in less 
than ten minutes. The pulsations of the heart were not present, 
so he states, for a minute before death. 3 Vomiting occurred in 
only one case. Brodie likewise performed the same experiment 
upon cats, with like results. Mussey 4 states the case of a horse 
which was killed by the injection into the stomach of an infusion 
of tobacco and also that of a calf, who, being washed with a 
tobacco infusion, for the purpose of killing vermin, died in 
consequence. 

1 Horn's Archiv, 1824. 

2 Orfila: General System of Toxicology, 1817, vol. ii, page 211. 

3 There is probably some fallacy underlying this statement of Brodie's, 
since all other observers, including the writer, mention the heart's beating 
some time after the stoppage of respiration. 

4 An Essay on the Influence of Tobacco on Life and Health. By R. D. 
Mussey, m. d., Boston, 183G. 



70 THE USE OF TOBACCO. 

Dr. Murray states that frogs placed in a jar containing to- 
bacco smoke became soporose, panted, and finally died. He 
also killed a sparrow and a magpie in the same manner. 

The writer performed the same experiment on the frog, the 
principal symptom noticed being an absolute relaxation of the 
whole body, so that the batrachian lay prone on his belly, with 
his limbs limp and powerless. 

Several experiments were likewise performed by Mussey on 
rats and cats, the distilled oil of tobacco being used. He found 
the rats were less affected by the poison than the cats, and that 
the younger the animal, the more rapid the toxic effect. 

In 1846, Wright, of Birmingham 1 (England), found that 
when two to live grains of the essential oil of tobacco was given 
to dogs two or three times a day, gradual and complete maras- 
mus came on, accompanied by a dragging of the hind legs, loss 
of sexual power, shriveling and softening of the testicles, shed- 
ding of the hair, and later on, sloughing of the eyelids and 
blindness. The post-mortem lesions consisted in fluidity of the 
blood, which was deficient in fibrin and was lacking in red cor- 
puscles. The heart was pale, small and soft. Rigor mortis 
never came on, and decomposition rapidly ensued. Before the 
experiments were fully under way, the gums became sore and 
bleeding; often the teeth dropped out. The mucous membranes 
of the mouth and air passages were tumid and more vascular 
than normal. 

An account is given of a black snake into whose mouth was 
thrown some tobacco juice. The reptile writhed in spasms for 
a short time and then died. 2 

M. Melier performed many experiments on dogs and cats with 
Xicotine, which he injected subcutaneously, in doses of from rive 
to eight drops. The breathing was, in most of the cases, affected 
first, and was noted as difficult and anxious; the pupils were 
dilated, and the animals staggered in their gait; violent efforts 
at defecation came on, with a copious discharge of "urine, ap- 

1 Am. Jour. Med. Sci., Jan.. 1847. 

2 Boston Med. and Surg. Jour., Oct., 1856, p. 216. 



THERAPEUTIC USES AND EFFECTS. 71 

parently followed by relief; at a point further on there was 
vomiting, trembling, and in some instances, a rapid movement 
of the ears, with frothy mucus running from the mouth." 

" When death occurred, it was preceded by signs of complete 
exhaustion, and more remotely, by convulsions. The exhaustion 
and convulsions appeared to affect the hind legs chiefly." 

The writer injected 1 -^ drop of Nicotine into a full-grown 
rabbit, and in a short time the animal became restless, followed, 
in an instant, by great quietness, and evidently, an inability or 
disinclination to move. This was followed, shortly after, by a 
rapid hopping around the room, accompanied by the expulsion 
of urine with sufficient force to send the liquid over the floor 
for at least two feet from the rabbit; there was defecation, fol- 
lowed by the animal toppling over and dying, evidently from 
failure of respiration, the time between the administration of 
the drug and death being about five minutes. 



PART FIFTH. 



THERAPEUTIC USES AND EFFECTS OF 
TOBACCO. 

In considering the use of tobacco as a therapeutic agent, we 
must be prepared to act as critics of the array of facts brought 
before us, and try to decide whether its advantages are greater 
than its disadvantages, or vice versa. The chief reasons against 
the use of the drug in medicine are as follows: — 

First. Its virulence as a poison. 

Second. Its general effects on the whole system as well as on 
the part of the system which we desire to affect. 

Third. Its nauseating odor to some people. 

Fourth. The difficulty in obtaining a uniform strength in the 
crude drug. 

Fifth. The unexpected and insidious action of the drug on 
those who, by idiosyncrasy, are not fit subjects for its use. 
1 Subcutaneously. 
F 



72 THE USE OF TOBACCO. 

In regard to the excessively poisonous properties of tobacco, 
we can only stop for one moment and consider that many of the 
drugs in use every day are just as poisonous, if not more so, and 
that idiosyncrasy governs their administration more closely than 
that of tobacco, in many cases. The writer does not think it just 
that a drug should be professionally tabooed solely because of 
its poisonous qualities, and he thinks that the reader will cer- 
tainly, in this respect, agree with him. Many of our most 
potent and useful drugs are poisonous in far smaller doses than 
even the pure Nicotine, and many of them, too, kill, by acting 
as heart depressants. Once stop the heart by a poison, and the 
man dies; but depress or stop respiration, and artificial and ex- 
ternal measures can be easily undertaken which will supply the 
necessary air for life. Let us consider as proven, therefore, that 
as far as its poisonous properties alone are concerned, tobacco 
may be considered as a useful member of our Pharmacopoeia. 

The second reason against its use is far more forcible than the 
first, and might be considered strong enough to entirely prevent 
its use, provided that some other drug could be used with equally 
advantageous, or partially advantageous, results. Given a case 
of threatened asthma in a woman, or one unaccustomed to smok- 
ing, and give as a cure for the threatened attack a strong cigar, 
and you ward off an attack of asthma, only to throw your patient 
into a condition so utterly miserable that she would gladly stand 
her asthma, thinking the remedy worse than the disease. You 
would bring on a great nausea and a feeling of general malaise, 
and, perhaps, dangerous vital depression. It is impossible to 
limit the effects of tobacco to any one portion of the body; and 
while this may be true of other drugs, still, many of them do not 
produce the unpleasant symptoms caused by tobacco. 

The general characteristics of a drug are really important 
factors in their use, very frequently. It is a generally under- 
stood fact among practitioners that the old Misturse Diabolicee of 
our forefathers, while often potent and efficient, formed a stepping 
stone for such dogmas as homoeopathy and kindred sugar-coated 
infinitesimals. 



THERAPEUTIC USES AND EFFECTS. 73 

This is certainly so as regards children, for parents dislike 
forcing their children to take doses which they themselves regard 
only as horrible alternatives, and they are ever ready to believe 
that as long as a medicine tastes good, it is better than that 
which is otherwise. 

The medical practitioner who prescribes ever so wisely and 
appropriately for a patient, but who is utterly regardless as to 
his combinations of drugs, as far as taste is concerned, will, sooner 
or later, see a more ignorant man take from him that practice 
which his greater wisdom entitles him to, but which is driven 
from him by his own mistake in this matter. While in some 
cases there is no alternative but to give a bad dose, in the subject 
before us we find many alternatives, or rather substitutes, for 
tobacco, whose powers as depresso-motors are fully as great, and 
far less disgusting and repulsive in their administration and 
effects. 

The difficulty in obtaining the drug with a uniform strength 
is one which militates strongly against its use. The difference 
in the proportion of its active principle being very great, ac- 
cording to the variety used; and even if a particular kind of 
tobacco was ordered for the preparation of the officinal article, 
it is probable that other varieties would soon creep into the drug 
store. 

Idiosyncrasy on the part of the patient has already been 
touched on. While it is true that other drugs, in their adminis- 
tration, are governed by the peculiarities of the patient, it should 
not be forgotten that the drug is so largely used as a luxury, 
that in certain cases the most heroic doses would have no effects, 
while to a person not accustomed to the action of the drug, 
comparatively minute doses would be followed by dangerous 
consequences. The action of the remedy is so sudden and in- 
sidious, that no amount of care could prevent accidents, which 
would test the best talent of the physician to overcome. Al- 
though tobacco was at one time considerably used for various 
purposes in medicine, it has, at the present day, fallen out of 
professional favor. That this disuse of the drug has been de- 



74 THE USE OF TOBACCO. 

served seems proven, both by what has just been said and the 
array of eases of accidental poisoning which have already been 
cited. However this may be, it is interesting and instructive to 
recite brief! v some of its former uses as a mediciual agent. 

Tetanus has probably been the field where tobacco has done 
the best work, at least in combating very serious diseases, since 
its action is so largely depresso-motor as to preclude its use in 
any disease but one of extreme nervous excitement. Before more 
rapidly-acting and less dangerous drugs of a depresso-motor 
character were known or understood, tobacco stood almost as the 
sole reliance of the surgeon who had such cases to govern. It 
seems to have been used equally frequently in both traumatic 
and idiopathic tetanus, and the results were about as satisfactory 
in one instance as the other. 

Its use in idiopathic tetanus was much earlier than in the 
traumatic form, and in the latter cases its use was first reported 
in 1815. 

The table on the opposite page shows quite a number of cases 
in which tobacco was used with good results in both forms of 
this horrible disease. At first sight, these statistics would, ap- 
parently, show that the drug was a good agent in combating 
tetanus, but it must not be forgotten that the cases in which it 
was used with no effect are not included in this table, and, as 
has been said before, other drugs can do the work better and 
with greater certainty and far less danger. Dr. Curling, 1 in 
speaking of tobacco in this connection, says, that the full etfects 
vf the drug are so peculiarly distressing, that patients often 
refuse to take any more of the preparation. A dose must be 
certainly very vile which a man suffering from tetanus would 
refuse, although it was supposed by him to be his only hope for 
relief. Mr. Curling found in his collection of nineteen tetanic 
cases, treated in this way, that nine recovered, and he asserts 
that in no case where the tobacco was given previous to consti- 
tutional loss of power and was fully and fairly tried, was there 
a single death. He does not state that it is always of avail, but 
1 Treatise on Tetanus. London, 1836. 



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76 THE USE OF TOBACCO. 

believes it to be the best remedy for tetanus at the time he 
writes. 

M. Cavenne, who wrote on the same subject at the same time, 
but whose paper was original, in that he was ignorant of the 
paper of Mr. Curling, reported quite a number of cases of both 
varieties of tetanus treated in this manner, and in all of which 
favorable results were obtained. 1 The writer has been unable 
to see the original report of the article, and, therefore, cannot 
give any more of the details in regard to cases, except that they 
were all treated by injection into the rectum. 

Mr. Curling (loc. cit.) recommends the administration of a 
sufficient quantity at first to thoroughly impress the system, and 
that enough of the drug should be given afterward to maintain 
the effects. He advises the use of a scruple of tobacco leaf made 
into an infusion by the addition of eight ounces of water for the 
first dose, and either a stronger or weaker infusion for the other 
doses, according to the condition of the patient. 

As tetanus was combated at one time by tobacco or its alka- 
loid, it is not surprising that its ally, strychnia poisoning, should 
have been treated on the same plan, and several favorable results 
were obtained. Dr. O'Reilly, of St. Louis, cured a person who 
had ingested six grains of strychnia by the use of an infusion of 
tobacco, in 1857. In 1862, Dr. Smyly, of Dublin, cured a boy 
who had taken about four grains of strychnia. In another case, 
reported in the British and Foreign Medico- Chirurgical Review, 
for January, 1867, a cure was effected by the use of a strong 
infusion of the drug, although the convulsions were very severe 
indeed. This case was one of attempted suicide, and the amount 
of the poison was three grains. Prof. Haughton, of Dublin, 
performed, in 1856, some very interesting experiments in regard 
to the antagonistic effects of Nicotine and strychnia. 2 They 
consisted in placing frogs in solutions of strychnia and Nicotine, 
and noting the length of time, in each case, before death came on. 

1 On the Employment of Tobacco in the Treatment of Tetanus. Bull, de 
l'Acad., i, 193 

2 Am. Journal Med. Sci., April, 1857, p. 551. 



THERAPEUTIC USES AND EFFECTS. 77 

In other experiments, he placed the frogs alternately in the two 
solutions, and the latter part of his paper is here quoted: — a In 
the fifth experiment, the frog lived forty-seven minutes in a 
mixture of the two solutions, of which one would have destroyed 
life in four minutes, and the other would have produced paralysis 
in one minute and destroyed life in three minutes; and yet in 
the mixture the animal lived forty-seven minutes, and afterward 
twenty-four hours. In the sixth experiment, the frog, immersed 
in a similar mixture of the poisons for ten minutes, had ulti- 
mately recovered, the effect of the strychnia being entirely obvi- 
ated by the Nicotine." 

In 1877, Haynes proved, very conclusively, that Nicotine and 
strychnia were not antagonistic, and even went as far as to state 
that, on the contrary, they were similar in their action. 1 His 
experiments were made on rats, cats, rabbits and dogs, and were 
one hundred and forty-three in number. He concludes, from 
twenty-one experiments, that the minimum fatal dose for a rat 
is Yg-ff of a drop of Nicotine, the average weight of the rats being 
about ten and one-quarter ounces. The conclusions which he 
draws are summed up by him as follows: — 

1st. Strychnia and Nicotine are in no degree antagonistic 
poisons. 

2d. Strychnia increases the convulsive action of Nicotine, and 
does not diminish the motor paralysis of the same. 

3d. Nicotine (even in paralyzing doses) increases the convul- 
sive action of strychnia. 

4th. Both poisons cause death by paralyzing the respiratory 
apparatus. They may affect respiration in different ways, but 
the result is the same. 

5th. Animals may be killed by injecting together doses of the 
two drugs, which, singly, are not fatal. 

He then goes on to say: — "It may not be out of place to 

mention the fact, that experimentation has proven that Nicotine 

and strychnia show a remarkable similarity in their intimate 

action on the nervous system, both being excitants of the spinal 

1 Phila. Med. Times, vol. vii, p. 363. 



78 THE USE OF TOBACCO. 

cord and paralyzers of the motor or efferent nerves." 1 Although 
the writer quoted is certainly right in stating what he does in 
regard to the similarity of action of the two drugs on the nervous 
system, it is but fair that the whole state of the case should be 
given to the attention of the reader. The actions of the two 
drugs may be summed up briefly and completely in a few words. 
Strychnia produces convulsions, by stimulating the motor tract of 
the spinal cord. The convulsions of Nicotine poisoning in the 
first stage may be due, possibly, to temporary excitation of the 
same tract, but, probably, are due to paralysis of the spinal in- 
hibitory centres in the cord. 2 If the Nicotine convulsions are 
due to excitation, then the actions of Nicotine and strychnia are 
identical, but only so in part, since Nicotine goes on and de- 
presses the cord, and strychnia does not do so. If the convul- 
sions of Nicotine are due to the depression of the reflex inhibi- 
tory centres, then the actions of the two drugs are different, but 
their effects are the SAME, in this first stage. Haynes, as already 
stated, found that the Nicotine increased the convulsions of 
strychnia. If the Nicotine produces the effect on the spinal 
inhibitory centres mentioned above, it will readily be seen how 
Nicotine does increase strychnia convulsions, viz., by paralyzing 
the only power which could by any chance control the strychnia 
movements, viz., the reflex spinal inhibitory centres. 

Thus it will be seen that in the first stage, although the drugs 
do not act in the same way, they nevertheless are not antagon- 
istic, but rather aid each other. Later on in the poisoning, by 
either drug, the motor nerves become paralyzed, but this paresis 
takes place very late in strychnia poisoning and very early, 
comparatively, in poisoning by Nicotine. 

To the writer's mind, Dr. Haynes' paper proves very con- 
clusively, both by theory and practical research, that Nicotine 
should not be used as an antagonist to strychnia; that his 
statement in regard to their both being spinal excitants is 

1 Dr. Haynes refers here, by a foot-note, to H. C. Wood's Therapeutics, 
in support of his statements. 

2 See Action on the Nervous System. 



THERAPEUTIC USES AND EFFECTS. 79 

incorrect, and bis statement "that Nicotine and strychnia show 
a remarkable similarity in their intimate action on the nervous 
system" is only partially the truth, and is, therefore, calculated 
to mislead. No one would ever think of classing Nicotine and 
tobacco with strychnia as excito-motors. 

Tobacco has been used in many other diseases than those 
already mentioned, such as spasmodic asthma, strangulated hernia, 
ascarides, pneumonia, haemoptysis, whooping-cough. As usual, 
it has been claimed that tobacco is a remedy for epilepsy. In 
dropsies, tobacco would appear to be really efficacious, and a 
number of favorable results have already been mentioned in 
this paper. 1 Spasmodic croup, spasm of the glottis and allied 
troubles have also been treated by means of this agent. The 
use of tobacco externally is really often of value, and in pruritus 
it is almost a specific. In various skin diseases, such as urticaria, 
pityriasis, etc., tobacco has been superseded by more safe and 
sure drugs. Hemorrhoids have also been relieved, when pain- 
ful, by bathing them with an infusion of tobacco. Applied to 
gouty and rheumatic joints, tobacco often gives relief, but the 
dangerous results which may ensue on its absorption should 
never be forgotten. 

Before closing this part of the article, it may be well to give 
the treatment of tobacco poisoning, both in its mild form, such 
as is seen every day in the small boy, and in its more serious 
aspect, as the accidental swallowing of some of the poison in 
large quantities. 

The use of ammonia and alcohol internally, and the former 
held to the nostrils as well, is not only indicated by the symp- 
toms, but also by our knowledge of the action of the drug. 
The dose should be small and frequently repeated. When the 
poisoning is sufficiently severe to cause serious symptoms and 
great alarm, the stomach should be relieved by an emetic or 
stomach pump. Dry heat should be applied, together with rub- 
bings and artificial respiration. Alcohol, ammonia and digitalis 
may be administered, the latter hypodermically. 

1 See Physiological Action on the General System. 



SO THE USE OF TOBACCO. 

APPENDIX. 

Although the matter contained in this appendix is not. strictly 
speaking, included in the meaning or aim of this paper, the 
writer thinks it interesting enough to engage the mind of the 
reader. It shows the enormous amount':: so which this 

country produces, and also, on the principle of the supply I ■- 
_ -. ^med by the demand, the large amount of the drug which 
sunied. 

The tables^ show the value per pound, yield per acre, value 
per acre, of the crops of 1881, 1^S2 and IS S3, and also the 
estimated area, product and value of the tobacco crops from 1868 
to 1883, inclusive. It will be seen that in 1880 the production 
was 4*30.000,000 pounds, which is 120,000.000 pounds less than 
the year 1877. The census of 1880 showed a population in the 
United States of 25.417,581 males and 24.632.284 females. 
Assuming that three- four:..- is number smoke, the re- 

maining one-fourth, consisting of those who do not use the 
"weed" at all and children who are too young to smoke as a 
e rind that we have to divide a production of 460.000,000 
ads among 19,063.186 smokers. If this be carried out still 
further, we rind that each smoker would consume twei 
pounds of tobacco per annum, or an allowance grains of 

aoo a day, which would be represented by a little less than 
s.ven cigars a day. To be sure, much of this tobacco is, of 
se, exported, but this is somewhat counterbalanced by the 
importation of foreign tobacco, particularly Havana. 

Assuming, again, that tobacco contains, on the average. 2 four 
per cent, of Xicotine, then in every hundi ns of tobacco 

we would have four grains of the most virulent of poisons, and 
the man who smoked 505 grains of tobacco a day would thus 
be exposed to over twenty grains of the poison, which he fortu- 
nately, as before stated, escapes, owing to the volatility and 
destruction of the poison by the heat. 

The question as to whether t : :< is harmful, when used as 

1 See :igts 82-85. 

2 See page 1-t, for Tables of Percentages. 



APPENDIX. 81 

a luxury, has been dealt with so fully already in this paper, that 
anything further which the writer might add would be super- 
fluous ; but it may not be out of place to sum up, very concisely, 
the evidence and opinions expressed. 

Tobacco does no harm, when used in moderation — to the man 
who, by occupation, leads an outdoor life, or one in which much 
physical exercise is taken, but rather does good, by quieting any 
tendency to continued action which may exist; to those who, by 
exceptionally long use, have become inured to the effects of the 
drug, and whose systems depend on it; to those whose tempera- 
ments are naturally phlegmatic and easy going. 

Tobacco does harm to the young and not yet full grown; to 
the man of sedentary habits; to the nervous and those whose 
temperaments are easily excited; to the sickly and those who, 
by idiosyncrasy, are strongly affected by the drug. 

The methods of using tobacco which the writer considers most 
harmful will be found below, their harmfulness being in direct 
ratio with the order here given : — 

1st. Chewing. 

2d. Cigarette smoking. 

3d. Cigar smoking. 

4th. Pipe smoking. 

5th. Turkish pipe smoking. 

The quality of the drug governs the degree of its harmfulness 
more stringently in some cases than in others, as does also the 
character and constituents of the paper in which cigarettes are 
wrapped. This paper is not one in which a discussion of the 
impurities of manufactured tobacco would be proper, and the 
writer has not, therefore, taken such possibilities of harm into 
consideration. 

In conclusion, let the writer once more call the attention of 
the reader to the oft-repeated words "excess" and " moderation. " 
These two words, after all, form the keystones of the arches 
which writers on tobacco, pro and con, have raised. 



82 



THE USE OF TOBACCO. 



PRODUCT, AREA, VALUE, VALUE PER POUND, YIELD PER ACRE, AND VALUE PER 
ACRE, OF TOBACCO, FOR YEARS 1881, 1882, 18S3. 

1881. 



STATES 

AND 

TERRITORIES. 



New Hampshire... 

Vermont 

Massachusetts 

Connecticut 

New York 

New Jersey 

Pennsylvania 

Maryland 

Virginia 

North Carolina.... 

South Carolina 

Georgia 

Florida 

Alabama 

Mississippi 

Texas 

Arkansas 

Tennessee 

West Virginia 

Kentucky 

Ohio 

Michigan 

Indiana 

Illinois 

Wisconsin 

Missouri 

Other States and 
Territories 

Total 



Total 
Production. 



Pounds. 

172,551 

.132,736 

5,000,964 

13,763,759 

6,291,217 

181,689 

38,805,661 

25,869,218 

77,649,854 

24,827,532 

47,528 

242,758 

23,085 

466,133 

436,000 

217,950 

979,922 

22,157,300 

2,066,531 

163,037,700 

35,419,913 

87,706 

7,719,373 

3,346,195 

8,702,770 

12,233,959 



449,880,014 



Total 
Area. 



Acres. 

92 

85 

3,291 

8,753 

5,037 

169 

33,080 

38,265 

139,663 

56,071 

192 

1,004 

107 

2,110 

1,519 

716 

2,023 

40,286 

4,112 

232,911 

36,760 

176 

10,760 

5,062 

10,045 

13,950 



646,239 



Total Value. 



Dollars. 

20,706 

19,910 

750,144 

2,202,201 

880,770 

21,802 

5,044,735 

2,069,537 

6,677,907 

3,351,716 

6,653 

33,986 

4,617 

83,903 

74,121 

39,231 

82,313 

1,683,954 

175,655 

14,347,316 

2,833,593 

10,963 

578,952 

274,387 

1,087,846 

1,015,418 



43,372,336 



>*> 

"" 03 
PS S 

< 


Average 


Yield 
Per 

Acre. 


Cents. 


Pounds. 


12 


1876 


15 


1562 


15 


1520 


16 


1572 


14 


1249 


12 


1075 


13 


1173 


8 


676 


8.6 


556 


13.5 


443 


14 


248 


14 


242 


20 


216 


18 


221 


17 


287 


18 


304 


8.4 


484 


7.6 


550 


8.5 


503 


8.8 


700 


8 


964 


12.5 


498 


7.5 


717 


8.2 


661 


12.5 


866 


8.3 


877 


9.6 


696.1 



Average 

Value 

Per 

Acre. 



Doh. Cts. 

225.12 

234.30 

228.00 

251.52 

174.86 

129.00 

152.49 

54.08 

47.82 

59.80 

34.72 

33.88 

43.20 

39.78 

48.79 

54.72 

40.66 

41.80 

42.75 

61.60 

77.12 

62.25 

53.77 

54.20 

108.25 

72.79 



67.11 



APPENDIX. 
1882. 



83 



STATES 

AND 

TERRITORIES. 



New Hampshire. 

Vermont , 

Massachusetts , 

Connecticut 

New York 

New Jersey 

Pennsylvania 

Maryland 

Virginia 

North Carolina... 
South Carolina .. 

Georgia 

Florida , 

Alabama 

Mississippi 

Texas 

Arkansas 

Tennessee 

West Virginia 

Kentucky 

Ohio 

Michigan 

Indiana 

Illinois 

Wisconsin 

Missouri 

Other States and 
Territories.... 

Total 



Total 
Production. 



Pounds. 

155,296 

126,099 

4,250,819 

9,772,269 

9,751,386 

194,407 

31,044,529 

29,232,216 

89,297,332 

32,275,792 

50,380 

262,179 

24,239 

475,456 

462,171 

241,924 

1,175,906 

31,020,220 

2,169,858 

198,905,994 

33,648,917 

92,091 

9,108,860 

3,848,124 

10,443,324 



15,047,770 



513,077,558 



Total 
Area. 



Acres. 

110 

89 

2,962 

8,665 

8,059 

172 

29,772 

39,030 

143,853 

64,482 

202 

1,034 

160 

2,173 

1,595 

788 

2,124 

41,897 

4,235 

242,227 

33,819 

181 

11,298 

5,163 

11,250 



16,182 



671,522 



Total Value. 



Dollars. 

18,636 

19,393 

531,352 

1,270,396 

1,170,166 

21,385 

3,725,343 

1,753,933 

6,518,705 

3,873,095 

6,549 

36,705 

4,363 

71,318 

60,082 

33,869 

99,952 

2,078,355 

216,986 

15,912,480 

2,355,424 

11,972 

637,620 

307,850 

1,253,199 



1,203,822 



43,189,951 



k 
u 

< 


Average 

Yield 

Per 

Acre. 


Cents. 


Pounds. 


12 


1412 


13 


1417 


12.5 


1435 


13 


1128 


12 


1210 


11 


1130 


12 


1043 


6 


749 


7.3 


621 


12 


500 


13 


249 


14 


254 


18 


151 


15 


219 


13 


290 


14 


307 


8.5 


554 


6.7 


740 


10 


512 


8 


821 


7 


995 


13 


509 


7 


806 


8 


745 


12 


928 


... 


... 


8 


930 


8.4 


764 



Average 

Value 

Per 

Acre. 



Dols. Cts. 

169.44 

184.21 

179.37 

146.64 

145.20 

124.30 

125.16 

44.94 

45.33 

60.00 

32.37 

35.56 

27.18 

32.85 

37.70 

42.98 

47.09 

49.58 

51.20 

65.68 

69.65 

66.17 

56.42 

59.60 

111.36 



74.40 



64.18 



84 



THE USE OF TOBACCO. 
1883. 



STATES 

AND 

TERRITORIES. 



New Hampshire... 

Vermont 

Massachusetts 

Connecticut 

New York 

New Jersey 

Pennsylvania 

Maryland 

Virginia 

North Carolina.... 
South Carolina.... 

Georgia 

Florida 

Alabama 

Mississippi 

Texas 

Arkansas 

Tennessee 

West Virginia 

Kentucky 

Ohio 

Michigan 

Indiana 

Illinois 

Wisconsin 

Missouri 

Other States and 
Territories.... 

Total 



Total 
Production. 



Pounds. 



4,038,278 
9,576,824 
9,068,789 



36,322,099 
31,570,793 
67,865,972 
29,048,213 



28,538,602 

1,952,872 

171,059,155 

29,947,536 



8,471,240 

3,155,462 

5,743,828 

10,540,000 



Total 
Area. 



Acres. 

107 

2,814 
8,145 



28,879 

40,593 

129,996 

60,000 



2,300 
40,221 

4,108 

230,116 

32,128 

11,863 

5,679 

12,750 

15,400 

8,200 



Total Value. 



638,739 



Dollars. 

18,977 



533,053 
1,292,871 
1,178,943 



4,358,652 
2,052,102 
5,429,278 
3,631,027 



95,700 

1,712,316 

205,052 

14,711,087 

2,395,803 



635,343 
252,437 
631,821 
895,900 

425,000 



40,455,362 






Cents. 
13 

13.2 
13.5 
13 

12 

6.5 

8 
12.5 



8.7 
6 
10.5 
8.6 



7.5 

8 
11 
8.5 

12.5 



Average 

Yield 

Per 

Acre. 



Pounds. 
1364 

1435 
1176 
1667 

1258 

778 
522 
484 



478 
710 
475 
743 
932 

711 
556 
450 
684 

415 



707 



Average 

Yalce 

Per 

Acre. 



Dols. Cts. 

177.36 

189.43 
158.73 
216.72 

150.93 
50.55 
41.76 
60.52 



41.61 
42.57 

49.92 
63.93 
74.57 

53.56 
44.45 
49.55 
58.18 

51.83 



63.34 



Bureau of Statistics of the Department of Agriculture, 
Dec. 4th, 1881. 



J. R. DODGE, 

Statistician. 



APPENDIX. 



85 



ESTIMATED AREA, PRODUCT AND VALUE OF THE TOBACCO CROPS, FROM 
1868 TO 1883, INCLUSIVE. 



Years. 



1868 
1869 
1870 
1871 
1872 
1873 
1874 
1875 
1876 
1S77 
1878 
1S79 
1880 
1881 
1882 
1883 



Total 
Production. 



Pounds. 
402,000,000 
393,000,000 
385,000,000 
426,000,000 
480,000,000 
506,000,000 
315,000,000 
522,000,000 
535.000,000 
5S0,000,000 
429,200,000 
471,000,000 
460,000,000 
450,880,014 
513,077,558 
451,545,641 



Total Area 



Acres. 
536,000 
604,000 
575,000 
580,000 
584,600 
653,000 
500,000 
710,000 
733,000 
745,000 
580,000 
638,841 
610,000 
646,239 
671,522 
638,739 



Total 
Value. 



$42,612,000 
41,265,000 
38,500,000 
41,748,000 
49,920,000 
41,998,000 
34,650,000 
41,760,000 
39,590,000 
40,600,000 
32,190,000 
36,750,000 
39,100,000 
43,372,000 
43,189,951 
40,455,362 



Average 


Average 


Value 


Yield 


Per Pound. 


Per Acre. 


Cents. 


Pounds. 


10.6 


750 


10.5 


650.7 


10 


669.6 


9.8 


734.5 


10.4 


821.1 


8.3 


774.9 


11 


630 


8 


735.2 


7.4 


729.9 


7 


778.5 


7.5 


740 


7.8 


737.3 


8.5 


754.1 


9.6 


697.7 


8.4 


764 


9 


707 



Average 

Value 

Per Acre. 



579.50 
68.32 
66.96 
71.98 
85.39 
64.32 
69.30 
58.82 
54 01 
54.50 
55.50 
57.53 
64.10 
67.11 
64.18 
63.34 



Bureau of Statistics, Dep't of Agriculture, 
Dec. 4th, 1884. 



J. D. DODGE, 

Statistician. 



A SUMMARY OF THE PHYSIOLOGICAL ACTION. 
The conclusions which the writer has reached are as follows : — 

1. Tobacco smoking does not decrease the urine eliminated, 
but rather increases it. 

2. Tobacco does retard tissue waste. 

3. Tobacco and its alkaloid cause convulsions in the primary 
stage of the poisoning, by depressing the reflex inhibitory centres 
in the cord. 

4. It causes the palsy of the second stage, by paralyzing (a) 
the motor nerve trunks, (6) the motor tract of the spinal cord. 

5. That the sensory nerves are not affected by the drug. 

6. That Nicotine contracts the pupil, by stimulating the 
oculo-motor and paralyzing the sympathetic, this action being 
peripheral. 

7. That Nicotine primarily lowers the blood pressure and 
pulse rate; (a) secondarily, increases pressure and rate; (6) 
thirdly, decreases pressure. 

8. That the primary lowering of pressure and rate is due 
to pneumogastric stimulation, associated with vaso-motor dila- 
tation. 



8G THE USE OF TOBACCO. 

9. That the secondary stage is due to vaso- motor constriction 
and pneumogastric palsy. 

10. That the third stage is due to vaso-motor dilatation 
returning. 

11. That death in poisoning from this drug is due to failure 
of respiration, the action of the drug being centric. 

12. That the blood corpuscles are broken up and crenated 
by the action of the poison. 

13. That in death from Nicotine poisoning the blood shows 
changes in spectra. 

14. That death can be brought about by the cutaneous 
absorption of Nicotine. 

15. That tobacco increases intestinal peristalsis in moderate 
amounts, and produces tetanoid intestinal spasms in poisonous 
doses. 

16. That the liver seems to destroy the poison, although this 
destruction is participated in by any set of capillaries in other 
parts of the body. 

17. That tobacco smoking increases pulse rate and decreases 
arterial pressure. 




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SPHYGMOGRAPHIC TRACINGS OF RADIAL PULSE AFTER 
TOBACCO SMOKING, AND BEFORE. 



All tracings taken in 13 seconds. 



TRACINGS TAKEN AFTEK SUITER. 



NO TOBACCO USED. 



J ^vj 



12, or 60 per minute. 



12, or 60 per minute. 



12, or 60 per minute. 



= 14, or 70 per minute. 
AVERAGE = 12 J, or 62^ PER MINUTE. 



SPHYGMOGRAPPIIC TRACINGS OF RADIAL PULSE AFTER 
TOBACCO SMOKING, AND BEFORE.— Continued. 

All tracings taken in 13 seconds. 
TRACINGS TAKEN AFTER SUPPER. TOBACCO USED, ONE CIGARETTE. 




14, or 70 per minute. 




15, or 75 per minute. 




14, or 70 per minute. 



= 14, or 70 per minute. 
AVERAGE = 14^, or 71% PER MINUTE. 



Average, with tobacco, 71*4 per minute. 
" without tobacco, 62% " '" 

Increase, 8% per minute. 



FISKE FUND PRIZE DISSERTATION, No. XXXIV. 



THE PHYSIOLOGICAL AND PATHOLOGICAL 



EFFECTS 



THE USE OF TOBACCO 



BY 



HOBART AMORY HARE, M.D. (Univ. of pa.), B.Sc., 

ONE OF THE ATTENDING PHYSICIANS TO THE DISPENSARY FOK THE DISEASES OF CHILD- 
REN, OF THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA ; 
ASSISTANT IN PHYSICAL DIAGNOSIS IN THE 
UNIVERSITY. 



PHILADELPHIA: 
P. BLAKISTON, SON & CO. 

1012 Wa lnut Street. 
1885. 



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